Journal of neurosurgical anesthesiology
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The 2007 literature pertaining to perioperative care of neurosurgical patients contains a wealth of articles. In this review, we provide a synopsis of common themes and unique contributions that are relevant to the care of patients with neurologic disorders who require either neurosurgical intervention or care in a neurosurgical-based intensive care unit.
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A positive correlation between brain temperature and intracranial pressure (ICP) has been proposed for patients under intensive care conditions. ⋯ These data do not support the notion of a clinically useful correlation between brain temperature and ICP.
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J Neurosurg Anesthesiol · Apr 2008
Predictors of difficult intubation in patients with cervical spine limitations.
Cervical spine function is of paramount importance to the management of the airway. What has not been reported in the literature is a systematic analysis of airway management in patients with cervical spine limitation (CSL) compared with their normal counterparts or a predictive model of difficult intubation (DI) in patients with CSL. ⋯ Limitations of cervical spine mobility are relatively common and increase the incidence of difficulty throughout the spectrum of airway management. DI should be anticipated in CSL patients who are > or =48 years old, have a Mallampati class 3 or 4, and a thyromental distance of <6 cm.
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J Neurosurg Anesthesiol · Apr 2008
Cardiovascular responses during percutaneous radiofrequency thermocoagulation therapy in primary trigeminal neuralgia.
Our objective was to observe and document cardiovascular side effects of radiofrequency thermocoagulation of the trigeminal ganglion. Forty-eight patients with primary trigeminal neuralgia were enrolled into this study. Continuous electrocardiogram, heart rate, cardiac rhythm changes, and systemic blood pressure were monitored during the procedure of oval foramen puncture, electrode needle stimulation, and lesion production. ⋯ The correlation between the intensity of the stimulus and the magnitude of the pressor response was positive when temperature during radiofrequency thermocoagulation was below 75 degrees C. That correlation became negative when the temperature exceeded 75 degrees C. We conclude that greater anticipatory awareness should be directed toward pressor than depressor responses during the procedures of percutaneous radiofrequency thermocoagulation therapy in primary trigeminal neuralgia.
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J Neurosurg Anesthesiol · Apr 2008
Glutamate-induced c-Jun expression in neuronal PC12 cells: the effects of ketamine and propofol.
Transcription factor c-Jun affects neuronal cell death and survival in mammalian brain. As general anesthetics, such as ketamine and propofol, are thought to provide some degree of neuroprotection, this study was intended to test whether the protection of injured neuronal PC12 cells by ketamine and propofol is related to the inhibition of phospho-c-Jun. Using neuronal PC12 cells from rat pheochromocytoma cells differentiated with nerve growth factor, we found that 24 hours of exposure to glutamate (1 to 100 mM) induced concentration-dependent cell death as determined by an ability to reduce the tetrazolium derivative, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) into a blue formazan salt. ⋯ Glutamate-induced cell death was reduced by ketamine (0.1, 1.0 mM) in a dose-dependent manner and also by propofol (0.5, 5.0 microM). In addition, the expression of phospho-c-Jun was substantially reduced by ketamine (0.1, 1.0 mM) and propofol (0.5, 5.0 microM), respectively, as determined by Western blot assay. These results suggest that inhibition of c-Jun activity is involved in the neuroprotective effects of ketamine and propofol on glutamate-induced injury in neuronal PC12 cells.