Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jan 2014
Survey of Anesthesiologists Practicing in American Neurointensive Care Units as Neurointensivists.
A group of anesthesiologists practice as intensivists in neurointensive care units (NeuroICU). The current nature and implications of the role of anesthesiology-based neurointensivist remain unclear. The purpose of this survey was to assess today's practice environment of anesthesiology-based neurointensivists as a framework for future study. ⋯ Anesthesiology-based neurointensivists currently represent a small subgroup within the rapidly growing neurointensivist workforce in the United States and consider neurocritical care a valuable aspect of their career. Promoting subspecialty training in neurocritical care among anesthesiologists may provide an opportunity for new patient-care frontiers and address the increasing need for NeuroICU physicians.
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J Neurosurg Anesthesiol · Jan 2014
Effect of Tracheostomy Timing on Clinical Outcome in Neurosurgical Patients: Early Versus Late Tracheostomy.
The optimal timing of tracheostomy in neurosurgical patients is not well established. This retrospective study was conducted to determine the effect of the timing of tracheostomy on clinical outcome in mechanically ventilated neurosurgical patients admitted to the surgical intensive care unit (ICU). ⋯ Early tracheostomy reduced the MV duration, ICU LOS, and incidence of VAP in critically ill neurosurgical patients. However, early tracheostomy did not reduce either the ICU or hospital mortality.
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J Neurosurg Anesthesiol · Jan 2014
Randomized Controlled Trial Comparative StudyRecovery from Anesthesia after Craniotomy for Supratentorial Tumors: Comparison of Propofol-Remifentanil and Sevoflurane-Sufentanil (the PROMIFLUNIL Trial).
Rapid recovery after supratentorial tumors (STT) removal is important. Short-acting anesthetics, such as propofol and remifentanil might favor this objective. The aim of this study was to compare the recovery of 2 Bispectral index (BIS)-guided anesthesia protocols combining sevoflurane-sufentanil (SS) or propofol-remifentanil (PR) administered during craniotomy for STT. ⋯ During craniotomy for STT, we could not demonstrate a reduction in the time to extubation when comparing a BIS-guided anesthesia associating PR to a BIS-guided anesthesia associating SS (Clinicatrials.gov identifier: NCT00389883).
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J Neurosurg Anesthesiol · Jan 2014
Randomized Controlled Trial Comparative StudyA Comparison of the GlideScope With the Macintosh Laryngoscope for Nasotracheal Intubation in Patients With Ankylosing Spondylitis.
The GlideScope (GS) video laryngoscope has been proven to be a suitable intubating device for a predicted difficult intubation. Patients with ankylosing spondylitis (AS) presented with particularly challenging airway management problems to the anesthesiologists. The benefits of using a GS in these patients have not been fully explored. The aim of this study was to evaluate the effectiveness of the GS, in comparison with the Macintosh laryngoscope, when performing nasotracheal intubation in patients with AS under general anesthesia. ⋯ The GS reduced the difficulty of tracheal intubation and provided a better laryngoscopic view with higher overall success rates and shorter duration of intubation attempts than the Macintosh laryngoscope. In our study, the GS proved to be a better alternative in most cases, compared with the Macintosh laryngoscope, for intubating AS patients who preferred their airway management under general anesthesia.