Anesteziologiia i reanimatologiia
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The review contains brief description of modem anesthetic approaches used in intractable epilepsy surgery. The authors describe main types of neurosurgery operations for intractable epilepsy, as well as the basic anesthetics and anesthetic plans and their influence on the intraoperative ECoG. Another issue raised is awake craniotomy - an anesthetic method with intraoperative emergence for verbal contact between patient and psychologist. We conclude that epilepsy surgery is one of the neurosurgery fields where anesthesiologist can significantly affect the outcome of the operation.
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Anesteziol Reanimatol · Jul 2011
Randomized Controlled Trial[Using of tranexamic acid (Tranexam) for prevention and correction of coagulopathy during brain tumors removal].
The aim of the study is to estimate clinical effectiveness of fibrinolysis inhibitor Tranexam in neurosurgical patients with intracranial tumors. The medication was prescribed to 78 patients from 27 to 65 years old. The control group consisted of 57 patients. ⋯ Drainage blood loss was lower in the main group (267 +/- 23 ml a day) than in the control group (340 +/- 28 ml a day). Medication injection during diffuse bleeding from small vessels led to quick and visible bleeding reduction. Thus Tranexam decreases the risk of intraoperative blood loss in the patients with brain tumors.
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Anesteziol Reanimatol · Jul 2011
[Intracranial pressure changes during xenon anesthesia in neurosurgical patients without intracranial hypertention].
Xenon assures rapid awakening and stable hemodynamics, it also has some neuroprotective effect. This is the reason why it may become an anesthetic of choice in neurosurgery. ⋯ We report a slight increase in intracranial and a slight decrease in cerebral perfusion pressure during xenon anesthesia and show that cerebrovascular reactivity is preserved. Thus we conclude that xenon anesthesia is safe for neurosurgical patients without intracranial hypertension.
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The study reports the results of monitoring the depth of anesthesia with BIS technology in 456 neurosurgical patients with different neurosurgical pathology: sub- and supratentorial tumors, aneurisms, arteriovenous malformations, spinal pathology, etc. BIS reflects hypnotic state of the brain during anesthesia in almost all the cases, except for bifon-tal surgical approach when sensor placement is impossible. BIS monitoring of the depth of anesthesia is most advantageous in the following cases: epilepsy surgery, spine surgery with neurophysiological monitoring, awake craniotomy, severe cardiovascular pathology, massive blood loss, neurosurgery in pregnant patients.
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Anesteziol Reanimatol · Jul 2011
[Impact of xenon anesthesia on cerebral oxygenation and metabolism in neurosurgical patients].
In recent years the background for xenon anesthesia implementation in neurosurgery has been created. A variety of researches have been conducted though very few of them concerned xenon effect upon cerebral metabolism. ⋯ Xenon inhalation was marked by higher jugular vein saturation, oxygen content and glucose level and lower arterio-venous difference. We conclude that compared to propofol xenon improves cerebral oxygenation and decreases cerebral metabolism in neurosurgical patients.