Articles: cations.
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Application of surgical skull pins causes hemodynamic fluctuations in neurosurgical procedures. To reduce this response, we describe the use of a novel nonpharmacologic method in the form of medical-grade sterile silicone studs to cushion the pressure of the skull pin in the adult population. This study aimed to evaluate the use of conventionally used fentanyl and medical-grade sterile silicone studs for the prevention of hemodynamic response to skull pin insertion. ⋯ The use of medical-grade silicone studs causes fewer hemodynamic fluctuations compared with fentanyl on skull pinning. Further studies with larger sample sizes are required to confirm the findings of this pilot study.
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J Neurosurg Anesthesiol · Jul 2023
Evaluation and Application of Ultra-Low-Resolution Pressure Reactivity Index in Moderate or Severe Traumatic Brain Injury.
The pressure reactivity index (PRx) has emerged as a surrogate method for the continuous bedside estimation of cerebral autoregulation and a predictor of unfavorable outcome after traumatic brain injury (TBI). However, calculation of PRx require continuous high-resolution monitoring currently limited to specialized intensive care units. The aim of this study was to evaluate a new index, the ultra-low-frequency PRx (UL-PRx) sampled at ∼0.0033 Hz at ∼5 minutes periods, and to investigate its association with outcome. ⋯ Our findings indicate that ultra-low-frequency sampling might provide sufficient resolution to derive information about the state of cerebrovascular autoregulation and prediction of 12-month outcome in TBI patients.