Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jan 2013
GuidelineNeuroanesthesiology fellowship training: curricular guidelines from the Society for Neuroscience in Anesthesiology and Critical Care.
Standardization and accreditation of fellowship training have been considered in the field of neuroanesthesiology. A prior survey of members of the Society for Neuroscience in Anesthesiology and Critical Care (SNACC) suggested strong support for accreditation and standardization. In response, SNACC created a Task Force that developed curricular guidelines for neuroanesthesiology fellowship training programs. These guidelines represent a first step toward standards for neuroanesthesiology training and will be useful if accreditation is pursued in the future.
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J Neurosurg Anesthesiol · Jan 2013
Randomized Controlled TrialBIS-guided anesthesia decreases postoperative delirium and cognitive decline.
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J Neurosurg Anesthesiol · Jan 2013
Aerosolized lidocaine during invasive mechanical ventilation: in vitro characterization and clinical efficiency to prevent systemic and cerebral hemodynamic changes induced by endotracheal suctioning in head-injured patients.
In patients with severe brain injury, endotracheal suctioning (ETS) can increase intracranial pressure (ICP) and reduce cerebral perfusion pressure (CPP). The aim of this prospective, blinded clinical trial was to assess the effectiveness of aerosolized lidocaine to prevent increase of ICP induced by ETS in mechanically ventilated head-injured patients. ⋯ Aerosolized lidocaine (2 mg/kg) can prevent ETS-induced increases in ICP, without modifying systemic and cerebral hemodynamics in deeply sedated patients.
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J Neurosurg Anesthesiol · Jan 2013
Randomized Controlled TrialThe effect of intraoperative infusion of dexmedetomidine on the quality of recovery after major spinal surgery.
Surgery induces a variety of metabolic, endocrine, and immune changes collectively known as the "stress response," which may often lead to prolonged postoperative convalescence. Anesthetic management may modulate this physiological response, thus affecting the postoperative course. We hypothesized that the intraoperative administration of dexmedetomidine (DEX), a sympatholytic agent, would reduce the stress response and improve the quality of recovery in patients undergoing major surgery. ⋯ DEX infusion during multilevel spinal fusions moderately improved the quality of recovery and possibly reduced fatigue in the early postoperative period. Moreover, it reduced plasma levels of cortisol and IL-10 in comparison with the control group. Our sample size was not sufficient to detect differences either in the incidence of complications or in clinically relevant outcomes.