Incidence and risk factors of postoperative delirium in patients admitted to the ICU after elective intracranial surgery: A prospective cohort study

CONCLUSION POD is prevalent in patients after elective intracranial surgery. The identified risk factors for and the potential association of POD with adverse outcomes suggest that a comprehensive strategy involving screening for predisposing factors and early prevention of modifiable factors should be established in this population. TRIAL REGISTRATION ClinicalTrials.gov NCT03087838.
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Perioperative medicine Source Type: research

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CONCLUSION: These data show that bilateral scalp blocks using bupivacaine with epinephrine did not reduce mean postoperative VAS score or overall opioid consumption at 24 hr nor the time-to-discharge from the postanesthesia care unit or from hospital. TRIAL REGISTRATION: www.ClinicalTrials.gov, NCT00972790; registered 9 September, 2009. PMID: 31879855 [PubMed - as supplied by publisher]
Source: Canadian Journal of Anaesthesia - Category: Anesthesiology Authors: Tags: Can J Anaesth Source Type: research
Conclusion: Scalp block might be useful at <6 h postcraniotomy with very-low quality evidence. Additionally, it had uncertain but moderate effect on reducing total 24 h opioid consumption. Therefore, more studies are needed to reach optimal information size.
Source: Indian Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
Background: Gabapentin is an adjuvant antiepileptic agent and helps to reduce acute postoperative pain in several surgery settings. However, the effect of gabapentin on postoperative pain from suboccipital or subtemporal craniotomy is not clear. Methods: The study was a single-center, randomized, placebo-controlled, and double-blinded trial. A total of 122 patients undergoing elective craniotomy by a suboccipital or subtemporal approach were randomly allocated to a placebo group and gabapentin group. The patients received gabapentin (600 mg, orally) the night before surgery and 2 hours before anesthesia inducti...
Source: Journal of Neurosurgical Anesthesiology - Category: Anesthesiology Tags: Clinical Investigations Source Type: research
Conclusion: Intraoperative infusion of lignocaine and magnesium results in lower VAS score and decreases the postoperative opioid requirement in patients undergoing craniotomy for excision of supratentorial tumors.
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
Purpose of review To explore the data for and against the use of the various components of multimodal analgesia in cranial neurosurgery. Recent findings Postcraniotomy pain is a challenging clinical problem in that analgesia must be accomplished without affecting neurologic function (i.e. ‘losing the neurologic exam’). The traditional approach with low-dose opioids is often insufficient and can cause well recognized side effects. Newer multimodal analgesic approaches have proven beneficial in a variety of other surgical patient populations. The combined use of multiple nonopioid analgesics offers the promi...
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: NEUROANESTHESIA: Edited by Lingzhong Meng Source Type: research
CONCLUSION: In infants, the greater occipital nerve can be blocked approximately 23mm from the external occipital protuberance, medial to the occipital artery. This distance is equal to the width of the medial three fingers at the proximal interphalangeal joint of the patient. This article is protected by copyright. All rights reserved. PMID: 31270900 [PubMed - as supplied by publisher]
Source: Paediatric Anaesthesia - Category: Anesthesiology Authors: Tags: Paediatr Anaesth Source Type: research
The purpose of this study was to compare the effects of scalp nerve block (SNB) and local anesthetic infiltration (LA) with 0.75% ropivacaine on postoperative inflammatory response, intraoperative hemodynamic ...
Source: BMC Anesthesiology - Category: Anesthesiology Authors: Tags: Research article Source Type: research
Pain is often observed in pediatric patients after craniotomy procedures, which could lead to some serious postoperative complications. However, the optimal formula for postoperative analgesia for pediatric ne...
Source: BMC Anesthesiology - Category: Anesthesiology Authors: Tags: Research article Source Type: research
Conclusion: In neurosurgical patients undergoing elective supratentorial craniotomy, ANI measures response to noxious stimuli with at least as much reliability as hemodynamic variables and changes in ANI parallel the changes in HR and MAP. ANI is superior to RE for measurement of response to noxious stimuli.
Source: Journal of Neurosurgical Anesthesiology - Category: Anesthesiology Tags: Clinical Reports Source Type: research
Purpose of review The current review reports on current trends in the anesthetic management of awake craniotomy, including preoperative preparation, sedation schemes, pain management, and prevention of intraoperative complications. Recent findings Both approaches for anesthesia for awake craniotomy, asleep–awake–asleep and monitored anesthesia care (MAC), have shown equal efficacy for performing intraoperative brain mapping. Choice of the appropriate scheme is currently based mainly on the preferences of the particular anesthesiologist. Dexmedetomidine has demonstrated high efficacy and safety in MAC for a...
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: NEUROANESTHESIA: Edited by Federico Bilotta Source Type: research
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