Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jul 2022
Brain and Heart Crosstalk During Neurointerventional Procedures: The Role of the Trigeminocardiac Reflex: An Updated Systematic Review.
The trigeminocardiac reflex is a well-described brainstem reflex that clinically manifests as bradycardia, hypotension, or apnea. This physiological phenomenon is extensively reported during open neurosurgical procedures, but very few data exist for trigeminocardiac reflex occurrence during neurointerventional procedures. This systematic review aims to provide aggregated information related to the trigeminocardiac reflex during neurointerventional procedures and to improve understanding of the various mechanisms that can incite this unique brain-heart crosstalk.
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J Neurosurg Anesthesiol · Jul 2022
Wellbeing of Frontline Health Care Workers After the First SARS-CoV-2 Pandemic Surge at a Neuroscience Centre: A Cross-sectional Survey.
The coronavirus disease 2019 (COVID-19) pandemic has affected people of all ages, races, and socioeconomic groups, and placed extraordinary stress on health care workers (HCWs). We measured the prevalence of burnout and assessed wellbeing and quality of life (QoL) in HCWs at a single UK neuroscience center after the first pandemic surge. ⋯ Our findings highlight the prevalence of HCW burnout after the first surge of the pandemic, with an increased risk of burnout among nurses and staff from ethnic minority groups. Both nursing and staff from ethnic minority groups were also more fearful for their health. With ongoing pandemic surges, the impact on HCW wellbeing should be continuously assessed to ensure that local strategies to support staff wellbeing are diverse and inclusive.
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J Neurosurg Anesthesiol · Jul 2022
Randomized Controlled TrialSafety of Nitrous Oxide Anesthesia in a Selected Group of Patients Undergoing Neurosurgery: An Exploratory Subgroup Analysis of the ENIGMA Trials.
The Evaluation of Nitrous Oxide in the Gas Mixture for Anesthesia (ENIGMA)-I and ENIGMA-II were randomized clinical trials that assessed the safety of nitrous oxide anesthesia in patients undergoing noncardiac surgery. In this study, we performed an exploratory pooled analysis of both ENIGMA trials to assess the safety of nitrous oxide in a selected group of patients undergoing neurosurgery. ⋯ Nitrous oxide did not increase the risk of postoperative complications or prolonged length of hospital stay in the neurosurgical cohort enrolled in the ENIGMA-I and ENIGMA-II trials.
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J Neurosurg Anesthesiol · Jul 2022
ReviewUnder the Helmet: Perioperative Concussion-Review of Current Literature and Targets for Research.
Patients with recent concussion experience disruption in neurocellular and neurometabolic function that may persist beyond symptom resolution. Patients may require anesthesia to facilitate diagnostic or surgical procedures following concussion; these procedures may or may not be related to the injury that caused the patient to sustain a concussion. As our knowledge about concussion continues to advance, it is imperative that anesthesiologists remain up to date with current principles. This Focused Review will update readers on the latest concussion literature, discuss the potential impact of concussion on perianesthetic care, and identify knowledge gaps in our understanding of concussion.