Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Apr 1997
Jugular venous bulb oxygen saturation monitoring in arteriovenous malformation surgery.
We describe a case in which jugular venous bulb oxygen saturation (SjvO2) monitoring proved useful during the surgical resection of an intracranial arteriovenous malformation (AVM). Surgical resection of large intracranial AVMs may be followed by normal perfusion pressure breakthrough with brain swelling, hyperemia, and subsequent problems in achieving hemostasis. ⋯ In the case discussed, SjvO2 monitoring enabled assessment of the risk of postresection hyperemia preoperatively and permitted the degree and completeness of surgical AVM resection to be followed intraoperatively. During the normal perfusion pressure breakthrough bleeding which followed complete AVM resection, SjvO2 monitoring helped with safe management of the controlled hypotension that finally permitted hemostasis to be achieved.
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J Neurosurg Anesthesiol · Apr 1997
Jugular bulb oxygen saturation and middle cerebral blood flow velocity during cardiopulmonary bypass.
This study investigates changes of jugular bulb oxygen saturation (SjO2) measured by fiberoptic jugular bulb oximetry and changes of intracranial hemodynamics using transcranial Doppler sonography (TCD) during cardiopulmonary bypass (CPB) for coronary artery bypass graft (CABG) in 17 ASA III patients. Anesthesia was maintained with fentanyl, midazolam, and continuous infusion of etomidate. Hypothermic CPB (27 degrees C) was managed according to alpha-stat conditions. ⋯ However, a major alteration in the balance of the cerebral oxygen supply and demand may occur in response to rewarming despite increases in Vmean. Findings suggest inadequate increases in CBF to meet cerebral metabolic demand. Further investigations need to validate these findings with biochemical techniques and neuropsychological tests.
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We present two patients who each had a retained subarachnoid drain catheter broken during postoperative removal. Management of these fragments should be individualized. The fragment remained in one patient, but was removed in the other because of further procedures required for hydrocephalus. We discuss possible causes of this complication as well as suggestions for prevention.
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J Neurosurg Anesthesiol · Jan 1997
Comparative StudyQuotation accuracy in neuroanesthesiologic research.
A considerable number of quotational inaccuracies have been detected in medical and surgical publications in the past. Our study investigated the quotational accuracy of selected references of 32 scientific publications in six anesthesia journals referring to a single article published in a 1973 issue of the British Journal of Anaesthesia. ⋯ These results suggest that quotational inaccuracy is also evident in neuroanesthesiologic research. This problem deserves increased attention by authors as well as by reviewers and journal editors.