Journal of neurosurgical anesthesiology
-
J Neurosurg Anesthesiol · Jan 2024
Early Extubation After Elective Infratentorial Craniotomy: Results of the International PRICE Survey.
Early extubation, defined as removal of the endotracheal tube at the end of surgery before transfer to a designated postoperative care area, is associated with better outcomes after elective infratentorial craniotomy. The Predicting Infratentorial Craniotomy Extubation (PRICE) project was an international survey designed to estimate the rate of early extubation after elective infratentorial craniotomy, as reported by neuroanesthesiologists, neurosurgeons, and neurocritical care specialists. ⋯ The reported rate of early extubation after elective infratentorial craniotomy varies widely between institutions, with respondents from high-volume institutions reporting greater rates of early extubation than those from lower-volume centers. The course of surgery, evidence of bulbar dysfunction, and altered consciousness, appear to affect the decision to extubate early more than other predictors.
-
J Neurosurg Anesthesiol · Jan 2024
Observational StudyPrevalence and Predictors of Preoperative Anxiety in Patients With An Intracranial Supratentorial Neoplasm Undergoing Surgery.
Preoperative anxiety is common among patients, particularly in neurosurgical patients. The aim of the study was to evaluate the incidence and predictive factors of preoperative anxiety using the state anxiety scale of the State-Trait Anxiety Inventory (STAI-S) among patients undergoing elective craniotomy for a supratentorial neoplasm. This study also determined the optimal Amsterdam Preoperative Anxiety and Information Scale (APAIS) score for the identification of preoperative anxiety in this cohort. ⋯ Patients with supratentorial neoplasms have a high incidence of preoperative anxiety; an APAIS score of 10 is the optimal cutoff to identify anxious patients in the preoperative period. Need-for-information about surgery and right-sided tumor laterality are independent predictors of preoperative anxiety.
-
J Neurosurg Anesthesiol · Jan 2024
Observational StudyFactors Associated With Perioperative Hospital Acquired Pressure Injury in Patients Undergoing Spine Surgery in the Prone Position: A Prospective Observational Study.
Hospital acquired pressure injury (HAPI) is associated with poor clinical outcomes and high medical costs. Patients undergoing surgery in the prone position are particularly vulnerable to perioperative HAPI. This prospective observational study investigated the factors associated with HAPI in patients undergoing elective spine surgery in the prone position. ⋯ The incidence of perioperative HAPI was 24.7% in patients undergoing elective spine surgery in the prone position. Long duration of prone positioning and intraoperative acidosis were associated with increased development of perioperative HAPI.
-
J Neurosurg Anesthesiol · Jan 2024
Observational StudyEffect of Different Surgical Positions on the Changes in Cerebral Venous Drainage in Patients Undergoing Neurosurgery: A Prospective Observational Study.
Some patient positions employed to facilitate neurosurgery can compromise cerebral venous drainage and lead to increased intracranial pressure, intraoperative bleeding, and brain bulge. This study evaluated the impact of different surgical positions on internal jugular vein (IJV) flow as a measure of cerebral venous drainage and on optic nerve sheath diameter (ONSD) as an indirect assessment of intracranial pressure. ⋯ Mean IJV flow decreased from baseline following the final neurosurgical positioning. Ultrasound-guided assessment of IJV flow could be a useful tool to quantify position-related changes in IJV drainage.