Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Oct 2019
Retrospective Analysis of Perioperative Variables Associated With Postoperative Delirium and Other Adverse Outcomes in Older Patients After Spine Surgery.
The aim of this retrospective study was to identify perioperative variables predictive of the development of delirium in older surgical patients after spine surgery. ⋯ Postoperative delirium is a common complication in older patients after spine surgery, and there are several perioperative risk factors associated with its development.
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J Neurosurg Anesthesiol · Oct 2019
ReviewPerspectives on Dexmedetomidine Use for Neurosurgical Patients.
The α2-adrenergic receptor agonist dexmedetomidine has sedative, anxiolytic, analgesic, and sympatholytic effects. The potential advantages of neuroprotection, minimal impact on neuronal function, stable hemodynamics, opioid and anesthesia sparing effects, and minimal respiratory depression during awake procedures render it an effective anesthetic adjuvant in various neurosurgical settings. However, both the benefits and drawbacks of the use dexmedetomidine in neuroanesthesia should be considered. This narrative review will summarize the applications of dexmedetomidine in various neurosurgical settings, highlighting evidence regarding both its common and controversial uses.
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J Neurosurg Anesthesiol · Oct 2019
A Survey On Fever Monitoring and Management in Patients With Acute Brain Injury: The SUMMA Study.
Fever is common in patients with acute brain injury and worsens secondary brain injury and clinical outcomes. Currently, there is a lack of consensus on the definition of fever and its management. The aims of the survey were to explore: (a) fever definitions, (b) thresholds to trigger temperature management, and (c) therapeutic strategies to control fever. ⋯ In this survey we identified substantial variability in fever definition and application of temperature management in acute brain injury patients. These findings may be helpful in promoting educational interventions and in designing future studies on this topic.
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J Neurosurg Anesthesiol · Oct 2019
Case ReportsUrgent Repositioning After Venous Air Embolism During Intracranial Surgery in the Seated Position: A Case Series.
Venous air embolism (VAE) is a well-described complication of neurosurgical procedures performed in the seated position. Although most often clinically insignificant, VAE may result in hemodynamic or neurological compromise resulting in urgent change to a level position. The incidence, intraoperative course, and outcome in such patients are provided in this large retrospective study. ⋯ Extreme VAE during seated intracranial neurosurgical procedures is infrequent. Extreme VAE-associated CO2 exchange and hemodynamic consequences from VAE were transient, recovering quickly back to baseline without significant neurological or cardiopulmonary morbidity.