Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jul 2015
Randomized Controlled TrialDexmedetomidine as an Anesthetic Adjuvant in Patients Undergoing Transsphenoidal Resection of Pituitary Tumor.
Transnasal transsphenoidal (TNTS) resection of pituitary tumors involves wide fluctuation in hemodynamic parameter and causes hypertension and tachycardia due to intense noxious stimuli during various stages of surgery. None of routinely used anesthetic agents effectively blunts the undesirable hemodynamic responses, and therefore usually there is a need to use increased doses of anesthetic agents. Dexmedetomidine (DEX) an α-2 adrenergic receptor agonist, because its sympatholytic and antinociceptive properties may ensure optimal intraoperative hemodynamic stability during critical moments of surgical manipulation. In addition, DEX reduced the anesthetic requirement with rapid recovery at the end of surgery. The main aim of our study was to evaluate the effect of DEX on perioperative hemodynamics, anesthetic requirements, and recovery characteristics in patients undergoing TNTS resection of pituitary tumors. ⋯ DEX as an anesthetic adjuvant improved hemodynamic stability and decreased anesthetic requirements in patients undergoing TNTS resection of pituitary tumor. In addition, DEX provided better surgical field exposure conditions and early recovery from anesthesia.
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J Neurosurg Anesthesiol · Jul 2015
Randomized Controlled TrialProSeal Laryngeal Mask Airway Attenuates Systemic and Cerebral Hemodynamic Response During Awakening of Neurosurgical Patients: A Randomized Clinical Trial.
Extubation and emergence from anesthesia may lead to systemic and cerebral hemodynamic changes that endanger neurosurgical patients. We aimed to compare systemic and cerebral hemodynamic variables and cough incidence in neurosurgery patients emerging from general anesthesia with the standard procedure (endotracheal tube [ETT] extubation) or after replacement of the ETT with a laryngeal mask airway (LMA). ⋯ Replacing the ETT with the LMA before neurosurgical patients emerge from anesthesia results in a more favorable hemodynamic profile, less cerebral hyperemia, and a lower incidence of cough.
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J Neurosurg Anesthesiol · Jan 2015
Randomized Controlled Trial Comparative StudyComparative Study Between Isoflurane, Sevoflurane, and Desflurane in Neurosurgical Pediatric Patients Undergoing Craniotomy for Supratentorial Tumor Resection.
The aim of this prospective, comparative, randomized study was to compare the inhalational anesthetics isoflurane, sevoflurane, and desflurane in pediatric patients undergoing craniotomy for excision of supratentorial tumors. We assessed early postoperative recovery outcome, intraoperative hemodynamics, and degree of brain swelling, as well as postoperative vomiting and shivering. ⋯ Desflurane and sevoflurane can be used to facilitate early emergence from anesthesia in neurosurgical pediatric patients. Emergence times are shorter with desflurane or sevoflurane than with isoflurane. The patients who received desflurane or sevoflurane have similar intraoperative and postoperative incidence of adverse effects compared with those who received isoflurane. Thus, desflurane and sevoflurane can be considered as suitable for emergence in pediatric neurosurgical anesthesia.
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J Neurosurg Anesthesiol · Jan 2015
Randomized Controlled Trial Comparative StudyComparison of the I-gel Laryngeal Mask Airway With the LMA-Supreme for Airway Management in Patients Undergoing Elective Lumbar Vertebral Surgery.
The single-use supreme-laryngeal mask airway (LMA) [corrected] has been reported to be suitable for airway management in the prone position. However, there are a limited number of cases using the I-gel in the prone position. In this study, we compared the clinical use of the 2 devices in adult patients undergoing elective lumbar vertebral surgery in the prone position. ⋯ The I-gel laryngeal mask airway can also be used safely in airway management of patients undergoing lumbar surgery in the prone position as well as the LMA [corrected].
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J Neurosurg Anesthesiol · Jan 2015
Randomized Controlled Trial Comparative StudyA Comparison of Equivolume, Equiosmolar Solutions of Hypertonic Saline and Mannitol for Brain Relaxation in Patients Undergoing Elective Intracranial Tumor Surgery: A Randomized Clinical Trial.
Hyperosmolar solutions have been used in neurosurgery to modify brain bulk and prevent neurological deterioration. The purpose of the study was to compare the effects of equivolume, equiosmolar solutions of mannitol and hypertonic saline (HTS) on brain relaxation and postoperative complications in patients undergoing elective intracranial tumor surgery. ⋯ Our results suggest that HTS provides better brain relaxation than mannitol during elective intracranial tumor surgery.