Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Oct 2011
Randomized Controlled TrialEfficacy of prophylactic low dose of tranexamic acid in spinal fixation surgery: a randomized clinical trial.
Spinal fixation surgery is potentially associated with significant bleeding, often requiring multiple blood transfusions. Concern for the risks of transfusion-acquired infection and immune modulation effects of allogeneic blood has led to the investigation of various hemostatic agents such as tranexamic acid (TXA). The investigators hypothesized that a prophylactic low dose of TXA would reduce blood loss and transfusion requirements during spinal fixation surgery. ⋯ The administration of a prophylactic low dose of TXA did not have a significant effect in the management of intraoperative blood loss and transfusion requirements in patients undergoing spinal fixation surgery.
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J Neurosurg Anesthesiol · Oct 2011
Measuring preoperative anxiety in patients with intracranial tumors: the Amsterdam preoperative anxiety and information scale.
Preoperative anxiety is a major problem in patients with brain tumors and is of high clinical relevance. However, to date no instruments have been validated for the assessment of preoperative anxiety for this patient group. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) has shown promising results for the assessment of preoperative anxiety. The aim of this study was to determine its psychometric properties and the optimal cutoff score for patients with intracranial tumors to make it applicable in the neurosurgical setting. ⋯ Despite its brevity, the APAIS is valid and recommendable for the assessment of preoperative anxiety in patients with intracranial tumors. As this is the first validation study focusing on patients with severe diseases and major surgeries, we recommend the application of our cutoff scores also for patients similar to our study population with regard to disease and surgery severity.
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J Neurosurg Anesthesiol · Oct 2011
Clevidipine for controlled hypotension during spinal surgery in adolescents.
Clevidipine is an ultrashort-acting, intravenous calcium channel antagonist. Metabolism by blood and tissue esterases results in a half-life of 1 to 2 minutes. We present preliminary experience with this novel agent to provide controlled hypotension (CH) in a cohort of adolescents undergoing spinal surgery. ⋯ Clevidipine maintained the MAP at 50 to 65 mm Hg and provided CH. Mild tachycardia was noted in some patients with the occasional need for a β-adrenergic antagonist. No episodes of excessive hypotension were noted. Given its short half-life, clevidipine can be rapidly titrated to provide CH when changing levels of sympathetic stimulation may occur.
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J Neurosurg Anesthesiol · Oct 2011
Cerebrospinal fluid tenascin-C in cerebral vasospasm after aneurysmal subarachnoid hemorrhage.
Tenascin-C (TNC) has been reported to be a useful biomarker for the activity of inflammatory diseases. This study investigated the association between TNC levels in the cerebrospinal fluid (CSF) and symptomatic vasospasm after aneurysmal subarachnoid hemorrhage (SAH), and the prognostic value of TNC levels. ⋯ TNC in the CSF may be a useful biomarker for predicting subsequent development of cerebral vasospasm.