Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jan 2022
Awake Craniotomy Under 3-Tesla Intraoperative Magnetic Resonance Imaging: A Retrospective Descriptive Report and Canadian Institutional Experience.
The role of high-field 3-Tesla intraoperative magnetic resonance imaging (I-MRI) during awake craniotomy (AC) has not been extensively studied. We report the feasibility and safety of AC during 3-Tesla I-MRI. ⋯ Our institutional experience suggests that AC under 3-Tesla I-MRI could be an option for glioma resection, although firm conclusions cannot be drawn given the limited and heterogenous nature of our data. Future multicenter trials comparing anesthetic and imaging modalities for glioma resection are recommended.
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J Neurosurg Anesthesiol · Jan 2022
The Application of Regional Cerebral Oxygenation Monitoring in the Prediction of Cerebral Hypoperfusion During Carotid Endarterectomy.
The aim of this study was to assess the diagnostic ability of near-infrared spectroscopy-monitored regional cerebral oxygen saturation (rSO2) to detect cerebral hypoperfusion during internal carotid artery (ICA) clamping compared with motor and somatosensory evoked potential (EP) monitoring. ⋯ Decreases in rSO2 correlated with decreases in EP amplitude during ICA clamping. A relative reduction in rSO2 ≥16% could serve as a warning for clamping-associated cerebral hypoperfusion. The 8.9% false-positive rate is a potential clinical limitation of the use of rSO2 to predict postoperative neurological deficits.
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J Neurosurg Anesthesiol · Jan 2022
Risk Factors for Delayed Extubation Following High Posterior Cervical and Occipital Fusion.
Much has been written on initial airway management in patients undergoing cervical spine procedures, but comparatively less is known about extubation criteria. High cervical and occipital fusion procedures pose a particular risk for extubation given the potential for a reduced range of motion at the occiput-C1 and C1-C2 joints should reintubation be necessary. ⋯ The decision to extubate immediately postoperatively after high cervical and occipital fusion should be considered carefully as the morbidity associated with airway obstruction can be severe in this population, while negative effects of delayed extubation were not evident in our analysis.
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Translational science seeks to accelerate the multi-step process by which scientific discoveries are transformed into therapies that can improve the health of individuals and their communities. To facilitate crossing the traditional boundaries between basic and clinical research for instance, a systematic understanding of the scientific and operational principles that underlie each step of the translational cycle is developed to identify and address barriers to translation. Skills required by translational scientists, such as being systems thinkers and process innovators, overlap with those of anesthesiologists, and therefore, it is no surprise that anesthesiologists have contributed to this field. ⋯ This article highlights the characteristics that make anesthesiologists well suited to be translational scientists. We also discuss one example of anesthesiology contributing to the field of translational science during the COVID-19 pandemic. We show that anesthesiologists, regardless of their specific clinical or research interests, have the skill set to become effective and critical players in the field of translational science and emphasize the importance of continued leadership in this field to academic anesthesiology.