Journal of neurosurgical anesthesiology
-
J Neurosurg Anesthesiol · Jan 2014
Randomized Controlled Trial Comparative StudyEvaluating the Role of Flupirtine for Postcraniotomy Pain and Compare it With Diclofenac Sodium: A Prospective, Randomized, Double Blind, Placebo-controlled Study.
Patients undergoing craniotomy, experience moderate to severe pain in postoperative period. Flupirtine does not have side effects like sedation and increase postoperative bleeding, so it may be a useful analgesic in neurosurgical patients. We designed this prospective, randomized, double blind, placebo-controlled study to evaluate the role of flupirtine for postcraniotomy pain and compare it with diclofenac sodium. ⋯ We conclude that oral flupirtine 100 mg is safe and as effective as oral diclofenac sodium 50 mg in reducing postcraniotomy pain.
-
J Neurosurg Anesthesiol · Jan 2014
Risk of Needle-Stick Injuries Associated With the Use of Subdermal Needle Electrodes During Intraoperative Neurophysiologic Monitoring.
Subdermal needle electrodes are commonly used during intraoperative neurophysiologic monitoring (IONM). However, there is an associated risk of needle-stick exposure to the IONM technologist as well as other operating room personnel. We performed a retrospective study to investigate the incidence and circumstances of needle sticks related to the use of subdermal needle electrodes. ⋯ Needle-stick exposure from subdermal needle electrodes during IONM is an infrequent but distressing event occurring in 0.34% of our study group and was not limited to the IONM technologist. Although no infections occurred as a result of needle-stick exposure in this study, steps to minimize needle sticks should be taken during IONM.
-
J Neurosurg Anesthesiol · Jan 2014
Randomized Controlled Trial Comparative StudyThe Effects of Neuromuscular Blockade on Operating Conditions During General Anesthesia for Spinal Surgery.
Muscle relaxants are prescribed routinely for patients undergoing general anesthesia, but the requirement for paralysis in spinal surgery is unclear. This study compared the operating conditions of general anesthesia with and without a muscle relaxant on spinal surgery patients. ⋯ General anesthesia without muscle relaxant provides similar working conditions to those observed with muscle relaxant, and it is associated with earlier eye opening and extubation and higher level of consciousness on emergence from spinal surgery.
-
J Neurosurg Anesthesiol · Jan 2014
Observational StudyDay Surgery Craniotomy for Unruptured Cerebral Aneurysms: A Single Center Experience.
Ambulatory day surgery is an evolving specialty in line with demands of modern medicine, health care services, and economics, but its role in neurovascular surgery remains controversial. The purpose of this study was to describe our experience of patients undergoing elective clipping of intact cerebral aneurysms as day surgery. ⋯ Our data demonstrates that surgical clipping of unruptured cerebral aneurysms may be performed in an outpatient setting. Careful selection of day surgery candidates and postoperative assessment for complications is needed. Further research is needed to identify potential risk factors and to target patient subgroups for successful ambulatory surgery.
-
J Neurosurg Anesthesiol · Jan 2014
A Retrospective Analysis of Stridor After Vestibular Schwannoma Surgery.
Transient lower cranial nerve deficits may occur after surgery in the posterior cranial fossa. Stridor has been reported after cerebellopontine angle epidermoid resection. The aim of this retrospective study is to find out whether any preoperative, intraoperative, and postoperative factors lead to stridor after resection of vestibular schwannoma. ⋯ The identification of the exact etiology of stridor often is difficult. Our results suggest that stridor may be more likely in patients who were difficult to intubate, had longer duration of surgery, who develop facial and neck edema and upperlimb weakness, poor cough, and swallowing after surgery. Establishing airway patency with intubation of the trachea may be required if patients develop oxygen desaturation due to stridor.