Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jul 2017
Review Meta AnalysisEffects of Acupuncture in Anesthesia for Craniotomy: A Meta-Analysis.
Acupuncture treatment has been used in China for >2500 years, and at present it is used worldwide as a form of analgesia in patients with acute and chronic pain. Furthermore, acupuncture is regularly used not only as a single anesthetic technique but also as a supplement or in addition to general anesthesia (GA). ⋯ The analysis suggests that the complementary use of acupuncture for craniotomy has additional analgesic effects, reduces the needed amount of volatile anesthetic, reduces the onset of postoperative nausea and vomiting, and might have protective effects on brain tissue. Our findings may stimulate future randomized controlled trials to provide definitive recommendations.
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We reviewed manuscripts published in 2016 that are related to the care of neurosurgical patients or the perioperative care of patients with neurological diseases. We address the broad categories of general neurosurgery and neuroanesthesiology, anesthetic neurotoxicity and neuroprotection, stroke, traumatic brain injury, and nervous system monitoring.
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J Neurosurg Anesthesiol · Oct 2016
ReviewMolecular Mechanisms of Anesthetic Neurotoxicity: A Review of the Current Literature.
Data from epidemiologic studies and animal models have raised a concern that exposure to anesthetic agents during early postnatal life may cause lasting impairments in cognitive function. It is hypothesized that this is due to disruptions in brain development, but the mechanism underlying this toxic effect remains unknown. ⋯ The level of evidence for each putative mechanism is critically evaluated, and we attempt to draw connections between them where it is possible to do so. Although there are many promising avenues of research, at this time no consensus can be reached as to a definitive mechanism of injury.
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J Neurosurg Anesthesiol · Oct 2016
ReviewSummary of the Update Session on Clinical Neurotoxicity Studies.
During the Fifth Pediatric Anesthesia Neurodevelopmental Assessment Symposium, experts and stakeholders met to present and discuss recent advances made in the study of neurodevelopmental outcomes after exposure to anesthetic drugs in infants and children. This article summarizes the update of 5 ongoing clinical studies: General Anesthesia compared to Spinal Anesthesia, Toxicity of Remifentanil and Dexmedetomidine, Mayo Anesthesia Safety in Kids, the University of California San Francisco human cohort study, and Columbia University Medical Center Neonatal Magnetic Resonance Imaging study. The purpose of this summary is to discuss the contributions and limitations of these studies, how they fit into the published literature, and what questions remain to be answered.