Journal of neurosurgical anesthesiology
-
J Neurosurg Anesthesiol · Jan 2022
Radiographic Predictors of Difficult McGrath MAC Videolaryngoscopy in Patient Undergoing Cervical Spine Surgery.
McGrath MAC videolaryngoscopy is a useful technique for successful intubation in cervical spine-injured patients with manual in-line stabilization of the neck during intubation. We aimed to identify radiographic predictors of difficult McGrath MAC videolaryngoscopy in patient undergoing cervical spine surgery. ⋯ Radiographic variables indicating enlarged tongue relative to the oral cavity and limited neck extension were associated with difficult McGrath MAC videolaryngoscopy in patients undergoing cervical spine surgery with manual in-line cervical stabilization during intubation.
-
J Neurosurg Anesthesiol · Jan 2022
Clinical TrialElectroencephalographic Alpha and Delta Oscillation Dynamics in Response to Increasing Doses of Propofol.
The electroencephalogram (EEG) may be useful for monitoring anesthetic depth and avoiding overdose. We aimed to characterize EEG-recorded brain oscillations during increasing depth of anesthesia in a real-life surgical scenario. We hypothesized that alpha power and coherency will diminish as propofol dose increases between loss of consciousness (LOC) and an EEG burst suppression (BS) pattern. ⋯ We report compelling data regarding EEG patterns associated with increases in propofol dose. This information may more accurately define "therapeutic windows" for anesthesia and provide insights into brain dynamics that are sequentially affected by increased anesthetic doses.
-
J Neurosurg Anesthesiol · Jan 2022
Pituitary Dysfunction After Aneurysmal Subarachnoid Hemorrhage: A Prospective Cohort Study.
The prevalence of pituitary dysfunction after aneurysmal subarachnoid hemorrhage (aSAH) remains incompletely elucidated. Furthermore, it is not clear whether these abnormalities impact patient outcomes. The aim of this study was to evaluate the prevalence of pituitary dysfunction after aSAH and its effect on outcomes. ⋯ Pituitary dysfunction is common after aSAH, but does not affect 6 to 12-month clinical outcomes.
-
J Neurosurg Anesthesiol · Jan 2022
Observational StudyImpact of Ventilator-associated Pneumonia on Cerebrospinal Fluid Inflammation During Immunosuppression After Subarachnoid Hemorrhage: A Pilot Study.
Brain injuries can cause systemic immunosuppression, which in turn can lead to infections that adversely affect the injured brain and worsen clinical outcomes. This study aimed to investigate whether systemic infection, such as ventilator-associated pneumonia (VAP), induce intracranial inflammation in patients with subarachnoid hemorrhage (SAH). ⋯ VAP increased intracranial inflammatory responses in patients with SAH despite the occurrence of systemic immunosuppression. A better understanding of cell trafficking and their pleiotropic functions in brain injury is needed to define the optimal strategies for preventing infections in patients with SAH.
-
J Neurosurg Anesthesiol · Jan 2022
Feasibility of Full Neuromuscular Blockade During Transcranial Motor Evoked Potential Monitoring of Neurosurgical Procedures.
Transcranial motor evoked potential (TcMEP) monitoring is conventionally performed during surgical procedures without or with minimal neuromuscular blockade (NMB) because of its potential interference with signal interpretation. However, full blockade offers increased anesthetic management options and facilitates surgery. Here, the feasibility of TcMEP interpretation was assessed during full NMB in adult neurosurgical patients. ⋯ TcMEP interpretation may be feasible under greater levels of NMB than previously considered, allowing for monitoring with greater degrees of muscle relaxation. Consideration for monitoring TcMEP during full NMB should be made on a case-by-case basis, and baseline responses without blockade may predict which patients will have adequate responses for interpretation.