Journal of anesthesia
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Journal of anesthesia · Jan 2009
A review of perioperative complications during frameless stereotactic surgery: our institutional experience.
Frameless stereotactic neurosurgery is increasingly being used for the biopsy of intracranial tumors and the resection of deep-seated lesions where reliance on surface anatomic landmarks can be misleading, as well as in movement disorders, psychiatric disorders, seizure disorders, and chronic refractory pain. Nascent biological approaches, including gene therapy and stem-cell and tissue transplants for movement disorders, also utilize neuronavigational techniques. These procedures are complex and involve understanding of the basic principles and factors affecting neuronavigation. The procedure may appear to be simple, but serious complications may occur. ⋯ Awareness and vigilance can help in the early identification and better management of the above intraoperative complications.
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Journal of anesthesia · Jan 2009
Does high-dose opioid anesthesia exacerbate ischemic spinal cord injury in rabbits?
Intrathecal morphine given during a post-ischemic period has been reported to have the potential to exacerbate ischemic spinal cord injury. However, it remains unknown whether synthetic opioids administered systemically exacerbate ischemic injury. We sought to compare the damage of the spinal cord after transient spinal cord ischemia in rabbits anesthetized with three different regimens; isoflurane, fentanyl with isoflurane, and remifentanil with isoflurane. ⋯ Our results suggest that neither i.v. fentanyl nor i.v. remifentanil added to 0.5 MAC isoflurane exacerbated ischemic spinal cord injury in rabbits when compared to 1 MAC isoflurane.
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Journal of anesthesia · Jan 2009
Interaction between midazolam and serotonin in spinally mediated antinociception in rats.
Intrathecal administration of serotonin (5-HT) is antinociceptive through the involvement of spinal cord gamma-aminobutyric acid (GABA) receptors. Therefore, 5-HT would interact with the GABA agonist, midazolam, which is well known to exert spinally mediated antinociception in the spinal cord. The present study investigated the antinociceptive interaction between spinally administered 5-HT and midazolam, using two different rat nociceptive models. ⋯ The antinociceptive effects of intrathecal midazolam and 5-HT were additive on thermal acute and inflammatory facilitated stimuli, and synergistic on inflammatory acute stimulation.