Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Oct 2011
Randomized Controlled TrialEffects of prone and jackknife positioning on lumbar disc herniation surgery.
Intra-abdominal hypertension due to surgical position increases bleeding at the surgical site. In this study, we evaluated the impact of prone and jackknife position on intra-abdominal pressure (IAP), lung mechanics, blood loss at the surgical site, and duration of the surgical procedure on lumbar disc operations. ⋯ The jackknife position causes less IAP elevation and less surgical site bleeding compared with the prone position. The jackknife position is the preferred choice for single-level lumbar disc surgery in healthy, nonobese patients.
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J Neurosurg Anesthesiol · Oct 2011
Randomized Controlled TrialEfficacy of prophylactic low dose of tranexamic acid in spinal fixation surgery: a randomized clinical trial.
Spinal fixation surgery is potentially associated with significant bleeding, often requiring multiple blood transfusions. Concern for the risks of transfusion-acquired infection and immune modulation effects of allogeneic blood has led to the investigation of various hemostatic agents such as tranexamic acid (TXA). The investigators hypothesized that a prophylactic low dose of TXA would reduce blood loss and transfusion requirements during spinal fixation surgery. ⋯ The administration of a prophylactic low dose of TXA did not have a significant effect in the management of intraoperative blood loss and transfusion requirements in patients undergoing spinal fixation surgery.
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J Neurosurg Anesthesiol · Jul 2011
Randomized Controlled TrialPostoperative analgesic efficacy of intravenous dexketoprofen in lumbar disc surgery.
We investigated the postoperative analgesic efficacy and effect on total tramadol consumption of intravenous dexketoprofen trometamol, a new nonsteroidal anti-inflammatory drug, in patients that had undergone lumbar disc surgery. ⋯ We found that dexketoprofen was an effective analgesic for postdiscectomy pain when used alone or in addition to opioids. It is easy to administer and decreases tramadol consumption and opioid-related side effects.
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J Neurosurg Anesthesiol · Apr 2011
Randomized Controlled TrialGabapentin premedication decreases the hemodynamic response to skull pin insertion in patients undergoing craniotomy.
In patients undergoing craniotomy, skull pin insertion produces significant increases in heart rate (HR) and blood pressure. We investigated whether premedication with gabapentin would prevent or attenuate this increase. ⋯ In conclusion, 900 mg of gabapentin, administered orally 2 hours before induction of anesthesia along with lidocaine scalp infiltration abolished the hemodynamic response after skull pin insertion. Premedication with gabapentin alone significantly attenuated the SBP and MAP; however, HR responses were more variable. A larger trial is required to corroborate the findings of the study before clinical recommendations would be warranted.
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J Neurosurg Anesthesiol · Jan 2011
Randomized Controlled Trial Comparative StudyDeeper total intravenous anesthesia reduced the incidence of early postoperative cognitive dysfunction after microvascular decompression for facial spasm.
To investigate whether the depth of total intravenous anesthesia affects postoperative cognitive dysfunction. ⋯ Deeper total intravenous anesthesia can decrease the incidence of cognitive dysfunction in the early postoperative period.