Neurosurgery
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Randomized Controlled Trial
The Impact of Alvimopan on Return of Bowel Function After Major Spine Surgery - A Prospective, Randomized, Double-Blind Study.
Pain management following major spine surgery requires high doses of opioids and is associated with a risk of opioid-induced constipation. Peripheral mu-receptor antagonists decrease the gastrointestinal complications of perioperative systemic opioid administration without antagonizing the analgesic benefits of these drugs. ⋯ This study shows that the perioperative use of alvimopan significantly reduced the time to return of bowel function with no increase in postoperative opioid use despite a slight increase in pain scores.
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Randomized Controlled Trial
Withholding Perioperative Steroids in Patients Undergoing Transsphenoidal Resection for Pituitary Disease: Randomized Prospective Clinical Trial to Assess Safety.
Perioperative steroid protocols for patients undergoing transsphenoidal surgery (TSS) for pituitary pathology vary by institution. ⋯ Perioperative steroids can be safely withheld in patients with an intact HPA axis undergoing TSS. Although administration of perioperative glucocorticoids does not appear to increase the risk of complications, it may interfere with assessment of the HPA axis after surgery.
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Robert J. White is probably best known as the first neurosurgeon to perform successful "cephalic exchange" on monkeys in 1971. However, he was also a pioneer in the field of neurosurgery and contributed tremendously to the field of neuroanesthesia and bioethics. ⋯ In 2004 and 2006, White and colleagues were nominated for the Nobel Prize in Physiology and Medicine, with Harvey Cushing and Wilder Penfield being the only other 2 neurosurgeons ever to be nominated for the award. Aside from his career as a neurosurgeon, he was also an advisor to 2 popes and an advocate for animal research. By the end of his career, White performed over 10 000 brain operations and published over 1000 articles, which has pushed the frontiers of neurosurgical research.