World Neurosurg
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Postoperative pain following posterior fixation is caused not only by tissue injury during surgery and is related to inflammatory, neuropathic, and visceral pain. This study aims to answer the question, "Is there a role for gabapentinoids in reducing postoperative pain?" In addition, it demonstrates which gabapentinoids may be used, for how long, and at what dose. ⋯ Postoperative use of gabapentin for controlling early and late-stage pain is safe and effective. Single and high-dose gabapentin was the first choice. A single and high dose of pregabalin is the second choice.
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Mentorship programs are crucial for continuous medical education, improving personal confidence, knowledge, and skills, and have been associated with staff retention and overall career satisfaction. However, there are limited studies evaluating the effectiveness of mentorship programs in neurosurgery. The study aims to evaluate the effectiveness of mentorship programs in neurosurgery, focusing on knowledge and skill development, personal growth, and networking opportunities. ⋯ Mentorship programs are effective in advancing the skills and capabilities of medical students, junior residents, and physicians. Evaluation of their effectiveness should consider not only scientific knowledge but also practical capabilities, personal growth, and critical thinking development. Free-of-charge programs with diverse participants and overall effectiveness make such experiences unique compared to other mentorship opportunities.
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Tracheal traction exercise (TTE) has been proposed as a preventative measure for laryngopharyngeal complications following anterior cervical discectomy and fusion. However, the exact effects of TTE remain controversial. Therefore, we conducted a systematic review and meta-analysis of randomized controlled trials to evaluate the efficacy of TTE. ⋯ TTE can effectively reduce operation duration and postoperative dysphagia. However, it does not result in a significant difference in postoperative VAS.
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Aberrant right subclavian artery (ARSA) is a rare condition, but the most common anomaly of the aortic arch. Although neurointerventions via transradial access (TRA) are becoming increasingly popular worldwide, transradial carotid cannulation has been extremely challenging in patients with an ARSA. Herein, we present a case of ARSA-associated anterior communicating artery (ACoA) aneurysm that was successfully treated with a radial-specific 6F Simmons guiding sheath via left TRA. We also review the relevant literature. ⋯ Transradial anterior circulation intervention has been rarely used for patients with an ARSA due to unfavorable catheter trajectory. Left TRA using the 6F Simmons guiding sheath is a useful treatment option to address anterior circulation interventions for patients with an ARSA. Preoperative diagnosis of ARSA is necessary for the application of our method.
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Hemostasis is crucial in preventing hemorrhage during cranial neurosurgical procedures and maintaining visualization of the surgical field. There is significant variation in the availability of hemostatic methods across different settings and hemostatic techniques are being continuously developed over the decades of practicing neurosurgery. The aim of this article is to provide an outline of the potential methods to achieve hemostasis based on the sequential operative anatomy of a cranial operation. ⋯ Depending on the phase of the surgery and the anatomic structure involved, the selection of the appropriate hemostatic method is determined by the source of bleeding. Surgeon awareness of all the potential techniques that can be applied to achieve hemostasis is paramount, especially when faced with operative nuances and difficult-to-control bleeding during cranial neurosurgical procedures.