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Mannitol Improves Intraoperative Brain Relaxation in Patients With a Midline Shift Undergoing Supratentorial Tumor Surgery: A Randomized Controlled Trial
Background: Mannitol is widely used to reduce brain tissue swelling and improve brain relaxation during neurosurgery. However, the optimal dosage for patients with midline shift undergoing supratentorial tumor resection remains unclear. Methods: In this randomized, controlled double-blinded study, 204 patients with preoperative midline shift who underwent elective supratentorial brain tumor surgery were equally allocated to receive placebo or 0.7, 1.0, or 1.4 g/kg mannitol infusion. The primary outcome was the proportion of satisfactory brain relaxation. Results: Demographics and baseline characteristics were sim...
Source: Journal of Neurosurgical Anesthesiology - September 8, 2020 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

Perioperative Management of Direct Oral Anticoagulants in Intracranial Surgery
The use of direct oral anticoagulants is increasing rapidly, because of perceived benefits over older agents, such as predictable pharmacokinetics and a reduced risk of bleeding. Elderly patients, who are more likely to be prescribed these drugs, are also presenting for neurosurgical procedures more often. The combination of these factors will result in neurosurgeons and neuroanesthesiologists encountering patients prescribed direct oral anticoagulants on an increasingly frequent basis. This review provides a summary of the current evidence pertaining to the perioperative management of these drugs, in the context of electi...
Source: Journal of Neurosurgical Anesthesiology - September 8, 2020 Category: Anesthesiology Tags: Review Articles Source Type: research

Continuous Near-infrared Spectroscopy Monitoring in Adult Traumatic Brain Injury: A Systematic Review
Near-infrared spectroscopy (NIRS) may provide a noninvasive way to monitor cerebral oxygenation in patients with traumatic brain injury, therein allowing for timely intervention aimed at reversing regional brain tissue hypoxia. We conducted a systematic review of NIRS-based oximetry measurements and their association with (A) patient functional outcome (B) other neurophysiological parameters. We searched MEDLINE, EMBASE, SCOPUS, BIOSIS, GlobalHealth and Cochrane Databases from inception to December 2018 and relevant conference proceedings published over the last 5 years. A total of 42 studies meeting our inclusion criteria...
Source: Journal of Neurosurgical Anesthesiology - September 8, 2020 Category: Anesthesiology Tags: Review Articles Source Type: research

The Value of SNACC Membership: A Past President’s Perspective
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - September 8, 2020 Category: Anesthesiology Tags: Editorials Source Type: research

Neurocritical Care in Resource-limited Settings
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - September 8, 2020 Category: Anesthesiology Tags: Editorials Source Type: research

Diversity, Inclusion and Equity in the Journal of Neurosurgical Anesthesiology: A Look to the Future
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - September 8, 2020 Category: Anesthesiology Tags: Editorials Source Type: research

Securing Endotracheal Tube in a Bearded Patient Undergoing Surgery for Cerebellopontine Angle Tumor in Lateral Position—A Different Approach
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 9, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

Difficult Central Venous Cannulation: An Overlooked Intracranial Cause
No abstract available (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 9, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

Hypotension and Hypocapnia During General Anesthesia in Piglets: Study of S100b as an Acute Biomarker for Cerebral Tissue Injury
Conclusion: S100b did not increase following 60 minutes of systemic hypotension and/or hypocapnia during GA in piglets. In this setting, the use of S100b as a biomarker of cerebral cell tissue dysfunction cannot be supported. (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 9, 2020 Category: Anesthesiology Tags: Laboratory Investigation Source Type: research

Language Monitoring in Brain Surgery Under General Anesthesia
Conclusions: To our knowledge, this is the first demonstration that phonological processing can be measured during brain surgery under general anesthesia, suggesting that some language processing persists under the condition of unconsciousness. These results encourage further study of language processing under general anesthesia with the goal of making intraoperative neuromonitoring. (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 9, 2020 Category: Anesthesiology Tags: Short Report Source Type: research

Pulse Pressure Variations and Plethysmographic Variability Index Measured at Ear Are Able to Predict Fluid Responsiveness in the Sitting Position for Neurosurgery
Background: Pulse pressure variation (PPV) and plethysmographic variability index (PVI), dynamic indicators of preload dependence based on heart-lung interactions, are used to predict fluid responsiveness in mechanically ventilated patients in the supine position. The sitting position for neurosurgery, by changing intrathoracic blood volume, could affect the capacity of PPV and PVI to predict fluid responsiveness. The aim of the study was to assess the ability of PPV and PVI to predict fluid responsiveness during general anesthesia in the sitting position. Methods: In total, 31 patients were included after settling in...
Source: Journal of Neurosurgical Anesthesiology - June 9, 2020 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

High-fidelity Training Model for Measurement of Dynamic Optic Nerve Sheath Diameter Using Transorbital Ultrasonography
Conclusions: We have developed a clinically relevant model capable of simulating changes in ONSD in patients with normal and raised ICP. This model could be a valuable training tool to gain scanning experience in optic nerve ultrasonography, and improve operators’ technical abilities. (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 9, 2020 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

Cervical Spine Movement During Awake Orotracheal Intubation With Fiberoptic Scope and McGrath Videolaryngoscope in Patients Undergoing Surgery for Cervical Spine Instability: A Randomized Control Trial
The objective of this study was to compare cervical spine movement during awake FGI with those during awake McGrath videolaryngoscope-guided intubation (VGI) in patients undergoing surgery for cervical spine instability. Methods: Forty-six adult patients with upper cervical spine instability scheduled for stabilization surgery were randomized to awake FGI or awake VGI. Cervical spine movement during intubation was assessed by changes in lateral fluoroscopic-measured angles (α and β at C1/C2 and C3 levels, respectively) at 3 time points: T1, preintubation; T2, during intubation; T3, postintubation. Motor power was asse...
Source: Journal of Neurosurgical Anesthesiology - June 9, 2020 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

Intubating Laryngeal Mask Airway-assisted Flexible Bronchoscopic Intubation Is Associated With Reduced Cervical Spine Motion When Compared With C-MAC Video Laryngoscopy-guided Intubation: A Prospective Randomized Cross Over Trial
In this study we compared cervical spine movement during orotracheal intubation using an intubating laryngeal mask airway (LMA Fastrach) assisted flexible bronchoscope or video laryngoscope. Materials and Methods: In total, 40 consenting patients without history of abnormalities of cervical spine and planned for elective neuroradiologic interventions in the angiography suite were enrolled in this randomized crossover trial. Every patient was subjected to LMA Fastrach-guided flexible bronchoscopic as well as video laryngoscopy guided intubation. Cervical spine motion at the occipital bone, C1-C5 vertebrae, the occiput-C1...
Source: Journal of Neurosurgical Anesthesiology - June 9, 2020 Category: Anesthesiology Tags: Clinical Investigations Source Type: research

Near-infrared Spectroscopy–derived Cerebral Autoregulation Indices Independently Predict Clinical Outcome in Acutely Ill Comatose Patients
Conclusions: Averaged COx ≥0.05 is independently associated with short and long-term mortality and long-term severe disability in acutely comatose adults with neurological injury. We propose that COx ≥0.05 represents an accurate threshold to predict long-term functional outcome in acutely comatose adults. (Source: Journal of Neurosurgical Anesthesiology)
Source: Journal of Neurosurgical Anesthesiology - June 9, 2020 Category: Anesthesiology Tags: Clinical Investigations Source Type: research