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Neuroanesthesia and outcomes: evidence, opinions, and speculations on clinically relevant topics
The objective of this review is to identify outstanding topics most relevant to neuroanesthesia practice and patient outcomes. We discuss the role of awake craniotomy, choice of general anesthetic agents, monitoring of anesthetic ‘depth’, mannitol-induced diuresis, neurophysiological monitoring, hyperventilation, and cerebral hypoperfusion. Recent findings Awake craniotomy, although a technique likely underused, is associated with enhanced recovery after surgery and prolonged survival after brain tumor resection compared with surgery under general anesthesia. The choice of general anesthetic must balance patient and...
Source: Current Opinion in Anaesthesiology - August 30, 2019 Category: Anesthesiology Tags: NEUROANESTHESIA: Edited by Lingzhong Meng Source Type: research

The Outcome of Status Epilepticus and Long-Term Follow-Up
Conclusion: This study highlights the importance of regular care and patient follow-up. Introduction Status epilepticus (SE) is a condition and most extreme form of epilepsy (1), which leads to abnormal and prolonged seizure (at least 5 min). In case SE persists over 30 min, it may have severe long-term consequences (2). Referring to the new classification scheme of SE, there are two operational dimensions of the definition: time point 1 (T1) is associated with abnormally prolonged seizure, when therapy should be initiated, while time point 2 (T2) is related to the time of on-going seizure activity involving a risk...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology Source Type: research

Mild Sedation Exacerbates or Unmasks Focal Neurologic Dysfunction in Neurosurgical Patients with Supratentorial Brain Mass Lesions in a Drug-specific Manner
Conclusions Midazolam and propofol augmented or revealed neurologic dysfunction more frequently than fentanyl and dexmedetomidine at equivalent sedation levels. Patients with high-grade gliomas were more susceptible than those with low-grade gliomas.
Source: Anesthesiology - February 17, 2016 Category: Anesthesiology Source Type: research

Cerebral protection during neurosurgery and stroke
This article reviews the recent evidence on perioperative neuroprotection in patients undergoing brain surgery and in patients with acute stroke. Recent findings: With varying degrees of success, numerous pharmacological and nonpharmacological therapies have been employed to provide neuroprotection for patients during the perioperative period and after acute ischemic stroke (IAS). Recent studies have failed to demonstrate neuroprotective effects of intraoperative remifentanil or propofol use, although hypertonic saline may provide better brain relaxation than mannitol during elective intracranial surgery for tumor. Magnesi...
Source: Current Opinion in Anaesthesiology - September 3, 2015 Category: Anesthesiology Tags: NEUROANESTHESIA: Edited by Keith J. Ruskin Source Type: research