Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Apr 2011
Spatial memory using active allothetic place avoidance in adult rats after isoflurane anesthesia: a potential model for postoperative cognitive dysfunction.
We described a paradigm of active allothetic place avoidance (AAPA) as a measure of spatial memory in adult rats. We hypothesized that, pending successful AAPA training, treatment with isoflurane would trigger spatial memory deficits. ⋯ Control animals demonstrated increased active avoidance behavior in the AAPA task compared with isoflurane-treated animals. Animals exposed to 2-hour isoflurane general anesthetic had a reduction in the maximum path of avoidance measure up to 7 days postanesthesia, whereas gross spatial parameters such as number of entrances into the shock zone were not significantly different between groups. The AAPA model may prove useful in ascertaining the learning and memory deficits of postoperative cognitive dysfunction.
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J Neurosurg Anesthesiol · Apr 2011
Effects of propofol on electrocorticography in patients with intractable partial epilepsy.
Propofol's potential to trigger generalized tonic-clonic seizures and epileptic discharges is still controversial. The aim of this study was to investigate the incidence of epileptic discharges and epileptic seizures in epilepsy patients anesthetized with propofol. ⋯ Our results do not contraindicate the use of propofol in patients with partial epilepsy. While spike-burst-suppression-patterns were recorded under propofol, the small number of surgically treated patients limits conclusions concerning their predictive value for improved epilepsy surgery outcome.
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J Neurosurg Anesthesiol · Apr 2011
Randomized Controlled TrialGabapentin premedication decreases the hemodynamic response to skull pin insertion in patients undergoing craniotomy.
In patients undergoing craniotomy, skull pin insertion produces significant increases in heart rate (HR) and blood pressure. We investigated whether premedication with gabapentin would prevent or attenuate this increase. ⋯ In conclusion, 900 mg of gabapentin, administered orally 2 hours before induction of anesthesia along with lidocaine scalp infiltration abolished the hemodynamic response after skull pin insertion. Premedication with gabapentin alone significantly attenuated the SBP and MAP; however, HR responses were more variable. A larger trial is required to corroborate the findings of the study before clinical recommendations would be warranted.
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We provide a summary of the 2010 literature pertinent to the care of neurosurgical patients and those requiring neurocritical care. In addition, we address topics in the basic neurosciences as they relate to neuroanesthesiology. ⋯ We will review the broad categories of general neuroanesthesiology, with particular emphasis on cerebral physiology and pharmacology, intracranial hemorrhage, carotid artery disease, spine surgery, traumatic brain injury, neuroprotection, and neurotoxicity. When selecting articles for inclusion in this review, we gave priority to those publications that had: (1) new or novel information, (2) clinical utility, (3) a study design possessing appropriate statistical power, and/or (4) meaningful, unambiguous conclusions.