Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jan 2015
Randomized Controlled Trial Comparative StudySedation for Electroencephalography With Dexmedetomidine or Chloral Hydrate: A Comparative Study on the Qualitative and Quantitative Electroencephalogram Pattern.
Sedation for electroencephalography in uncooperative patients is a controversial issue because majority of sedatives, hypnotics, and general anesthetics interfere with the brain's electrical activity. Chloral hydrate (CH) is typically used for this sedation, and dexmedetomidine (DEX) was recently tested because preliminary data suggest that this drug does not affect the electroencephalogram (EEG). The aim of the present study was to compare the EEG pattern during DEX or CH sedation to test the hypothesis that both drugs exert similar effects on the EEG. ⋯ The differences of DEX and CH in EEG power did not change the EEG qualitative interpretation, which was similar with the 2 drugs. Other studies comparing natural sleep and sleep induced by these drugs are needed to clarify the clinical relevance of the observed EEG quantitative differences.
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J Neurosurg Anesthesiol · Jan 2015
Intravenously Administered Indocyanine Green May Cause Falsely High Near-Infrared Cerebral Oximetry Readings.
Near-infrared spectroscopy assesses cerebral tissue oxygen saturation (Scto2) based on the absorption spectra of oxygenated and deoxygenated hemoglobin. It has been reported that IV-administered dyes including methylene blue, indigo carmine, and indocyanine green (ICG) may cause falsely low-pulse oximetry readings (Spo2). Although methylene blue and indigo carmine may also decrease Scto2, the effect of ICG has not been documented. ⋯ ICG falsely increases the spectroscopy-determined cerebral oxygen saturation for up to 12 minutes but dampens pulse oximetry readings.
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J Neurosurg Anesthesiol · Jan 2015
Comparative StudyComparative Study of Trigeminocardiac Reflex After Trigeminal Ganglion Compression During Total Intravenous Anesthesia.
Percutaneous compression of the trigeminal ganglion (PCTG) is an alternative surgical treatment for trigeminal neuralgia (TN). Manipulation of PCTG can lead to significant hemodynamic changes, which may increase the risk of cardiovascular complications. However, to our knowledge, few studies have focused on anesthesia experience during PCTG as treatment for TN so far. It was our primary focus on how to ensure the stability of hemodynamics during our clinical anesthesia experience. This study aimed to compare the study group (using sodium nitroprusside [SNP] as soon as the puncture began) with the control group (without using SNP as soon as the puncture began) to investigate cardiovascular parameters (systolic blood pressure [SBP], diastolic blood pressure [DBP], and heart rate [HR]) at 5 periods during total intravenous anesthesia. ⋯ The control group and the study group were not able to prevent bradycardia elicited during PTCG. Compared with control group, dramatic elevations of the systemic blood pressure can be prevented using intravenous drip SNP as soon as the puncture began during total intravenous anesthesia in the study group. Our findings verify that intravenous drip SNP is an effective method to control abrupt rise of blood pressure.
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J Neurosurg Anesthesiol · Jan 2015
Prolonged Mechanical Ventilation is Associated With Pulmonary Complications, Increased Length of Stay, and Unfavorable Discharge Destination Among Patients With Subdural Hematoma.
Although subdural hematoma (SDH) is common in neurocritical practice, little is known about SDH patients requiring prolonged mechanical ventilation (PMV). We aimed to determine predictors of PMV and its relationship with outcome in patients with SDH. ⋯ PMV is associated with pulmonary complications, increased LOS, and unfavorable discharge destination in patients with SDH. Alcohol abuse, admission GCS, and surgical evacuation are associated with PMV among patients with SDH. Future studies should investigate the role of early tracheostomy in high-risk patients and impact on outcomes.