Journal of neurosurgical anesthesiology
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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.
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J Neurosurg Anesthesiol · Jan 1997
Intravenous lidocaine decreases but cocaine does not alter the rate of cerebrospinal fluid formation in anesthetized rabbits.
Considering that adrenergic stimulation was reported to decrease the rate of cerebrospinal fluid (CSF) formation (Vf), it was hypothesized that cocaine might exert a similar effect. Accordingly, the present study was designed to examine the effects of low, moderate, and high doses of cocaine on Vf and resistance to reabsorption of CSF (Ra). Because cocaine possesses both adrenergic-stimulating and local anesthetic properties, the present study examined the effects of lidocaine, a local anesthetic without adrenergic-stimulating properties, as a comparison treatment to cocaine. ⋯ In the lidocaine group there was a dose/time-related decrease of Vf (although the slope relating Vf to dose/time was not significantly different from that in the cocaine group), but no significant change of Ra. It is concluded that during halothane anesthesia cocaine does not decrease Vf, a finding not consistent with previous reports that adrenergic stimulation decreases Vf. Decrease of Vf with lidocaine is consistent with previous reports of similar dose-related effects of thiopental, etomidate, midazolam, and fentanyl on Vf.
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J Neurosurg Anesthesiol · Oct 1996
Case ReportsPercutaneous dilational tracheostomy after anterior cervical spine fixation.
After spinal cord injury, quadriplegic patients generally require tracheostomy for ventilatory support and airway clearance. Early tracheostomy has several advantages over translaryngeal intubation, but in patients who undergo anterior surgical fixation of the spine, it is often delayed until after recovery of the surgical wound. ⋯ The percutaneous dilational technique minimizes the injury to the adjacent structures of the neck and the risk of stomal infection. Therefore, it should be considered the technique of choice when an early tracheostomy is indicated for quadriplegic patients who have undergone anterior surgical fixation of the cervical spine.
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J Neurosurg Anesthesiol · Oct 1996
The effect of right internal jugular vein cannulation on intracranial pressure.
Access to the central venous circulation is often necessary in patients who have elevated intracranial pressure. It has been suggested that a disadvantage of the internal jugular vein approach to the central circulation may be an elevated intracranial pressure. The purpose of this prospective study was to evaluate the effect of right internal jugular vein cannulation on intracranial pressure in patients who are at risk of intracerebral hypertension. ⋯ Furthermore, no difference was found in percentage change from baseline intracranial pressure data throughout the study period. Our results suggest that cannulation of the right internal jugular vein is a safe approach to the central circulation in patients at risk of intracranial hypertension. A description of the possible accommodating mechanisms are outlined.