Abstracts From the 47th Annual Meeting of the Society for Neuroscience in Anesthesiology and Critical Care, Phoenix, AZ, September 12-14, 2019
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - September 9, 2019 Category: Anesthesiology Tags: Abstracts: PDF Only Source Type: research

Electrophysiological Monitoring During Percutaneous Trigeminal Nerve Ganglion Block
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - September 9, 2019 Category: Anesthesiology Tags: Correspondence Source Type: research

Reply to “Postoperative Delirium and EEG Monitoring”
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - September 9, 2019 Category: Anesthesiology Tags: Correspondence Source Type: research

Postoperative Delirium and EEG Monitoring
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - September 9, 2019 Category: Anesthesiology Tags: Correspondence Source Type: research

Optimizing Design for the Way Clinicians Use Critical Event Cognitive Aids
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - September 9, 2019 Category: Anesthesiology Tags: Correspondence Source Type: research

Journal Club
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - September 9, 2019 Category: Anesthesiology Tags: Journal Club Source Type: research

The Effect of Fluid Loading and Hypertonic Saline Solution on Cortical Cerebral Microcirculation and Glycocalyx Integrity
This study compared the short-term effects of liberal fluid loading with a restrictive fluid intake followed by osmotherapy with hypertonic saline (HTS) on cerebral cortical microcirculation and EG integrity in a rabbit craniotomy model. Methods: The experimental rabbits were allocated randomly to receive either (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - September 9, 2019 Category: Anesthesiology Tags: Laboratory Investigation Source Type: research

Portable Infrared Pupillometer in Patients With Subarachnoid Hemorrhage: Prognostic Value and Circadian Rhythm of the Neurological Pupil Index (NPi)
Background: Portable automated infrared pupillometry is becoming increasingly popular. To generate an objective reference base, the Neurological Pupil index (NPi) which combines different values of the pupillary light reflex is being introduced into clinical practice. In this explorative study, we examined different aspects of the NPi in relation to clinical severity and outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). Materials and Methods: Patients with serial assessment of the NPi (NeurOptics pupillometer NPi-200, Irvine, CA) starting no later than day 2 after aSAH onset were included in the stud...
Source: Journal of Neurosurgical Anesthesiology - September 9, 2019 Category: Anesthesiology Tags: Clinical Reports Source Type: research

Performance of Electrical Velocimetry for Noninvasive Cardiac Output Measurements in Perioperative Patients After Subarachnoid Hemorrhage
We examined the usefulness of a noninvasive electrical velocimetry (EV) device based on the thoracic bioimpedance method for perioperative hemodynamic monitoring in patients after aneurysmal subarachnoid hemorrhage. Patients and Methods: In total, 18 patients who underwent surgical clipping or endovascular coiling for ruptured aneurysms were examined prospectively. Simultaneous cardiac index (CI) measurements obtained with EV (CIEV) and reference transpulmonary thermodilution (CITPTD) were compared. A total of 223 pairs of data were collected. Results: A significant correlation was found between CIEV and CITPTD (r=0....
Source: Journal of Neurosurgical Anesthesiology - September 9, 2019 Category: Anesthesiology Tags: Clinical Reports Source Type: research

Urgent Repositioning After Venous Air Embolism During Intracranial Surgery in the Seated Position: A Case Series
Conclusions: Extreme VAE during seated intracranial neurosurgical procedures is infrequent. Extreme VAE-associated CO2 exchange and hemodynamic consequences from VAE were transient, recovering quickly back to baseline without significant neurological or cardiopulmonary morbidity. (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - September 9, 2019 Category: Anesthesiology Tags: Clinical Reports Source Type: research

Impact of CPAP on Forehead Near-infrared Spectroscopy Measurements in Patients With Acute Respiratory Failure: Truth or Illusion
Background: Critically ill patients with acute respiratory failure admitted to an intensive care unit are at high risk for cerebral hypoxia. We investigated the impact of continuous positive airway pressure (CPAP) therapy on regional cerebral tissue oxygenation (rSO2). Materials and Methods: In total, 40 extubated surgical intensive care unit patients requiring classic oxygen therapy (COT) for acute respiratory failure were examined. Near-infrared spectroscopy (INVOS 5100C, Covidien) was used for 30 minutes to detect bilateral rSO2 during COT via facemask (6 L/min) and CPAP therapy (40% fraction of inspired oxy...
Source: Journal of Neurosurgical Anesthesiology - September 9, 2019 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

A Survey on Fever Monitoring and Management in Patients With Acute Brain Injury: The SUMMA Study
Conclusions: In this survey we identified substantial variability in fever definition and application of temperature management in acute brain injury patients. These findings may be helpful in promoting educational interventions and in designing future studies on this topic. (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - September 9, 2019 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

Preoperative Gabapentin Administration Improves Acute Postoperative Analgesia in Patients Undergoing Craniotomy: A Randomized Controlled Trial
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 - September 9, 2019 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

Retrospective Analysis of Perioperative Variables Associated With Postoperative Delirium and Other Adverse Outcomes in Older Patients After Spine Surgery
Background: The aim of this retrospective study was to identify perioperative variables predictive of the development of delirium in older surgical patients after spine surgery. Materials and Methods: We collected preoperative, intraoperative, and postoperative data on patients 65 years of age and above having spine surgery between July 1, 2015 and March 15, 2017. The primary outcome was the development of postoperative delirium. Data were analyzed using univariate and multivariable analysis. Results: Among the 716 patients included in this study 127 (18%) developed postoperative delirium. On multivariable analysis...
Source: Journal of Neurosurgical Anesthesiology - September 9, 2019 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

Can Cerebral Near-infrared Spectroscopy Predict Cerebral Ischemic Events in Neurosurgical Patients? A Narrative Review of the Literature
Cerebral near-infrared spectroscopy (NIRS) is considered a valuable noninvasive modality for cerebral oxygenation monitoring during cardiovascular surgery and cardiac arrest. We assessed the capability of cerebral NIRS to predict cerebral desaturation and the related neurological outcomes in neurosurgical patients. A literature search in different electronic medical databases was performed from inception to January 2018. A total of 286 citations were found and finally 48 studies were retrieved, only 7 of these were eligible and included for review. A meta-analysis was not feasible because of high heterogeneity of patients&...
Source: Journal of Neurosurgical Anesthesiology - September 9, 2019 Category: Anesthesiology Tags: Review Articles Source Type: research

Perspectives on Dexmedetomidine Use for Neurosurgical Patients
The α2-adrenergic receptor agonist dexmedetomidine has sedative, anxiolytic, analgesic, and sympatholytic effects. The potential advantages of neuroprotection, minimal impact on neuronal function, stable hemodynamics, opioid and anesthesia sparing effects, and minimal respiratory depression during awake procedures render it an effective anesthetic adjuvant in various neurosurgical settings. However, both the benefits and drawbacks of the use dexmedetomidine in neuroanesthesia should be considered. This narrative review will summarize the applications of dexmedetomidine in various neurosurgical settings, highlighting ...
Source: Journal of Neurosurgical Anesthesiology - September 9, 2019 Category: Anesthesiology Tags: Review Articles Source Type: research

In Remembrance of Hiroshi Takeshita, MD, Pioneering Neuroanesthesiologist
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - September 9, 2019 Category: Anesthesiology Tags: Editorials Source Type: research

General Anesthetic Agents Are Not Neuroprotective and May Be Neurotoxic
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - September 9, 2019 Category: Anesthesiology Tags: Editorials Source Type: research

General Anesthetics Are Neuroprotective
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - September 9, 2019 Category: Anesthesiology Tags: Editorials Source Type: research

Put the Kibosh On Bias
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - September 9, 2019 Category: Anesthesiology Tags: Editorials Source Type: research

Scalp Block for Management of Subarachnoid Hemorrhage (SAH)-induced Headache
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 11, 2019 Category: Anesthesiology Tags: Departments Source Type: research

Dilated Pupil as a Diagnostic Component of Brain Death—Does it Really Matter?
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 11, 2019 Category: Anesthesiology Tags: Departments Source Type: research

An Unusual Case of Difficult Nasogastric Tube Insertion in a Patient With Displaced Cervical Spine Fracture
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 11, 2019 Category: Anesthesiology Tags: Departments Source Type: research

Bilateral Ultasound Guided Erector Spinae Plane Block for Postoperative Pain Management in Lumbar Spine Surgery: A Case Series
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 11, 2019 Category: Anesthesiology Tags: Departments Source Type: research

Journal Club
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 11, 2019 Category: Anesthesiology Tags: Departments Source Type: research

Effect of Dexmedetomidine on Cerebral Vasospasm and Associated Biomarkers in a Rat Subarachnoid Hemorrhage Model
Conclusions: DEX administration reduced the severity of cerebral vasospasm and improved neurological function in SAH rats; this may be closely linked to reduced CSF IL-6 levels. (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 11, 2019 Category: Anesthesiology Tags: Laboratory Investigation Source Type: research

Society for Neuroscience in Anesthesiology & Critical Care (SNACC) Neuroanesthesiology Education Milestones for Resident Education
Conclusions: The SNACC Neuroanesthesiology milestones provide a framework for reviewing resident performance and are expected to facilitate improved use of ACGME milestones during Neuroanesthesiology subspecialty training. The task force recommends that the target should be to accomplish level 4 or higher milestones by the end of residency training. Individual programs should decide the implications of a resident not meeting the expected milestones. (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 11, 2019 Category: Anesthesiology Tags: Clinical Report Source Type: research

A Modified Translaryngeal Tracheostomy Technique in the Neurointensive Care Unit. Rationale and Single-center Experience on 199 Acute Brain-damaged Patients
This study assessed the clinical impact of this technique in brain-injured patients. Materials and Methods: This is a retrospective analysis of prospectively collected data from adult brain-injured patients who had undergone modified TLT during the period spanning from January 2010 to December 2016 at the Neurointensive care unit, San Gerardo Hospital (Monza, Italy). The incidence of intraprocedural complications, including episodes of intracranial hypertension (intracranial pressure [ICP]>20 mm Hg), was documented. Neurological, ventilatory, and hemodynamic parameters were retrieved before, during, and...
Source: Journal of Neurosurgical Anesthesiology - June 11, 2019 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

Which Protocol for Milrinone to Treat Cerebral Vasospasm Associated With Subarachnoid Hemorrhage?
Conclusions: These findings indicate that a continuous IV infusion of milrinone was as efficient as combined IA+IV infusion and suggest that this modality could be considered as a first easy-to-use option to treat patients with CVS. (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 11, 2019 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

Selection of Patients’ Recumbent Position Laterality According to Physician Handedness Bias Increases the Success Rate of Lumbar Puncture: A Multicenter Study
Conclusions: Physicians handedness bias and patient laterality of recumbent position affects the success of LPs. Right-handed physicians have a greater chance of performing successful LPs when patients are in the left LRP, and vice versa. (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 11, 2019 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

Perioperative Hyperchloremia and its Association With Postoperative Acute Kidney Injury After Craniotomy for Primary Brain Tumor Resection: A Retrospective, Observational Study
Conclusions: Our study shows that perioperative hyperchloremia during PODs 0 to 3 was associated with an increased risk of postoperative AKI during this period after craniotomy for primary brain tumor resection. (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 11, 2019 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

Glasgow Coma Scale Score Fluctuations are Inversely Associated With a NIRS-based Index of Cerebral Autoregulation in Acutely Comatose Patients
Conclusions: This study showed that fluctuations in GCS scores are inversely associated with fluctuations in COx; as COx increases (impaired autoregulation), more severe neurological impairment is observed. However, the difference in COx between high and low GCS is small and warrants further studies investigating this association. CA multimodal monitoring with COx may have the potential to be used as a surrogate of neurological status when the neurological examination is not reliable (ie, sedation and paralytic drug administration). (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 11, 2019 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

Hemodynamic Management of Patients During Endovascular Treatment of Acute Ischemic Stroke Under Conscious Sedation: A Retrospective Cohort Study
Background: Anesthetic modality and hemodynamic management during mechanical thrombectomy (MT) for acute ischemic stroke (AIS) are potential contributors to the success of revascularization. The aims of our study were to review the hemodynamic management by anesthesiologists and clinical outcomes in patients undergoing MT under conscious sedation. Methods: Retrospective cohort study of patients with anterior circulation AIS from January 2012 to March 2016. Primary outcome was hemodynamic intervention, defined as administration of vasoactive drugs to maintain systolic blood pressure (BP) between 140 and 180 mm&t...
Source: Journal of Neurosurgical Anesthesiology - June 11, 2019 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

A Pilot Study of a Novel Automated Somatosensory Evoked Potential (SSEP) Monitoring Device for Detection and Prevention of Intraoperative Peripheral Nerve Injury in Total Shoulder Arthroplasty Surgery
Conclusions: A high incidence (19%) of intraoperative nerve insult was observed in this study demonstrating the feasibility of using an automated SSEP device to provide a timely alert and enable an intervention in order to minimize peripheral nerve injury during TSA. Further randomized studies are warranted. (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 11, 2019 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

General Anesthetic Use in Fragile X Spectrum Disorders
The fragile X premutation is characterized by a repeat expansion mutation (between 55 to 200 CGG repeats) in the fragile X mental retardation 1 (FMR1) gene, which leads to RNA toxicity at the cellular level. This may cause patients with the premutation to be particularly susceptible to environmental toxins, which could manifest clinically as new or worsening ataxia and memory loss. Multiple published case reports have also suggested general anesthetics as a potential toxin leading to negative side effects when used in patients with fragile X-associated disorders. However, at this time, there have been no formal research st...
Source: Journal of Neurosurgical Anesthesiology - June 11, 2019 Category: Anesthesiology Tags: Review Articles Source Type: research

Mannitol in Critical Care and Surgery Over 50+ Years: A Systematic Review of Randomized Controlled Trials and Complications With Meta-Analysis
Objective: Despite clinical use spanning 50+ years, questions remain concerning the optimal use of mannitol. The published reviews with meta-analysis frequently focused on mannitol’s effects on a specific physiological aspect such as intracranial pressure (ICP) in sometimes heterogeneous patient populations. A comprehensive review of mannitol’s effects, as well as side effects, is needed. Methods: The databases Medline (OvidSP), Embase (OvidSP), and NLM PubMed were systematically searched for randomized controlled trials (RCTs) comparing mannitol to a control therapy in either the critical care or perioper...
Source: Journal of Neurosurgical Anesthesiology - June 11, 2019 Category: Anesthesiology Tags: Review Articles Source Type: research

Intraoperative-evoked Potential Monitoring: From Homemade to Automated Systems
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 11, 2019 Category: Anesthesiology Tags: Editorials Source Type: research

The Role of Near-infrared Spectroscopy in Cerebral Autoregulation Monitoring
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 11, 2019 Category: Anesthesiology Tags: Editorials Source Type: research

Standardized Accreditation of Neuroanesthesiology Fellowship Programs Worldwide: The International Council on Perioperative Neuroscience Training (ICPNT)
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 11, 2019 Category: Anesthesiology Tags: Editorials Source Type: research

Editorial
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 11, 2019 Category: Anesthesiology Tags: Editorials Source Type: research

Acquired Central Hypoventilation Syndrome Unmasked by Propofol Sedation
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - March 9, 2019 Category: Anesthesiology Tags: Departments: Correspondence Source Type: research

Neurogenic Pulmonary Edema and Stunned Myocardium in a Patient With Meningioma: A Heart-Brain Cross Talk
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - March 9, 2019 Category: Anesthesiology Tags: Departments: Correspondence Source Type: research

Patent Foramen Ovale and Elective Posterior Fossa Craniotomy in the Park-bench Position: How Should We Proceed?
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - March 9, 2019 Category: Anesthesiology Tags: Departments: Correspondence Source Type: research

Pediatric High-flow Pial Arteriovenous Fistula (AVF) for Glue Embolization: An Anesthetic Challenge
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - March 9, 2019 Category: Anesthesiology Tags: Departments: Correspondence Source Type: research

Intraoperative Neuromonitoring During Sciatic Nerve Schwanomma Excision: Utility of Evoked Potentials
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - March 9, 2019 Category: Anesthesiology Tags: Departments: Correspondence Source Type: research

Journal Club
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - March 9, 2019 Category: Anesthesiology Tags: Departments: Journal Club Source Type: research

Effects of Branched-Chain Amino Acid Supplementation on Spontaneous Seizures and Neuronal Viability in a Model of Mesial Temporal Lobe Epilepsy
Conclusions: Acute BCAA supplementation reduces seizure propagation, whereas chronic oral supplementation with BCAAs worsens seizure propagation and causes neuron loss in rodents with mesial temporal lobe epilepsy. These findings raise the question of whether such supplementation has a similar effect in humans. (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - March 9, 2019 Category: Anesthesiology Tags: Laboratory Investigation Source Type: research

Regional Cerebral Oxygen Saturation Changes After Decompressive Craniectomy for Malignant Cerebral Venous Thrombosis: A Prospective Cohort Study
Conclusions: Patients with malignant CVT had a lower rSO2 on ipsilateral side of the lesion, which improved significantly after DC. Preoperative rSO2 was not correlated with the duration of hospital stay. (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - March 9, 2019 Category: Anesthesiology Tags: Clinical Investigations Source Type: research