Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Oct 2014
Randomized Controlled Trial Comparative StudyThe Brain Relaxation and Cerebral Metabolism in Stroke Volume Variation-directed Fluid Therapy During Supratentorial Tumors Resection: Crystalloid Solution Versus Colloid Solution.
Compared with goal-directed crystalloid therapy, goal-directed colloid therapy during high-risk surgery may improve postoperative outcome. Whether intraoperative fluid therapy based on goal-directed protocol with different types of fluid has distinctive effects on brain relaxation and cerebral metabolism during craniotomy remains unclear. ⋯ In patients undergoing supratentorial tumor resection, goal-directed HES therapy was not superior to goal-directed LR therapy for brain relaxation or cerebral metabolism, although less fluid was needed to maintain the target SVV in the HES-based group than in the LR-based group.
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J Neurosurg Anesthesiol · Oct 2014
Randomized Controlled Trial Comparative StudyDirect Comparison of the Effect of Desflurane and Sevoflurane on Intraoperative Motor-evoked Potentials Monitoring.
During spinal surgery, intraoperative monitoring of motor-evoked potentials (MEPs) is a useful means of assessing the intraoperative integrity of corticospinal pathways. However, MEPs are known to be particularly sensitive to the suppressive effects of inhalational halogenated anesthetic agents. ⋯ Inhalational anesthetic agents (sevoflurane >desflurane) suppress MEP amplitudes in a dose-dependent manner. The use of 0.3 MAC of desflurane (but not sevoflurane) provided good MEP recordings acceptable for clinical interpretation for both upper and LLs. The LL appears to be more sensitive to anesthetic-induced depression compared with the UL. All patients studied had normal neurological examination hence, these results may not be applicable to those with preexisting deficits.