Journal of neurosurgical anesthesiology最新文献

Increased Propofol Sensitivity Associated With Hearing Loss in Patients Undergoing Vestibular Schwannoma Surgery: A Retrospective Study. 前庭神经鞘瘤手术患者异丙酚敏感性增加与听力损失相关：一项回顾性研究。

IF 2.4 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-08-04 DOI: 10.1097/ANA.0000000000001054

Xuehua Zhou, Yiru Wang, Songyuan Chi, Guo Ran, Kaizheng Chen, Xia Shen

{"title":"Increased Propofol Sensitivity Associated With Hearing Loss in Patients Undergoing Vestibular Schwannoma Surgery: A Retrospective Study.","authors":"Xuehua Zhou, Yiru Wang, Songyuan Chi, Guo Ran, Kaizheng Chen, Xia Shen","doi":"10.1097/ANA.0000000000001054","DOIUrl":"https://doi.org/10.1097/ANA.0000000000001054","url":null,"abstract":"Background: Propofol is widely used in neurosurgery, with its dosage typically based on patient weight and variability. While factors like age, sex, and cognitive function are known to influence propofol requirements, the impact of preoperative hearing function remains underexplored. This study investigates the relationship between hearing loss and propofol sensitivity in vestibular schwannoma surgery patients.Methods: This retrospective study analyzed 475 patients who underwent vestibular schwannoma resection between May 12, 2020, and February 28, 2024. Total intravenous anesthesia (TIVA) with propofol and remifentanil was used, maintaining BIS values between 40 and 60. Hearing impairment was defined as a pure tone average (PTA) ≥20 dB. Multivariable linear regression was used to assess the relationship between preoperative hearing function and propofol requirements.Results: The hearing-impaired group was older (51.7±10.5 vs. 42.9±10.5 y, P<0.001) and required lower median (IQR) propofol doses (96.7 [85.2 to 115.2] vs. 109.0 [91.4 to 126.9] μg·kg-1·min-1, 95% CI: 5.511-15.016, P<0.001). In unadjusted analysis, hearing loss (PTA ≥20 dB) was associated with reduced propofol requirements (OR: -10.4, P<0.001). This association remained significant in multivariable analysis adjusting for age, sex, ASA, BMI, and anesthesia provider (ORadj: -5.0; 95% CI: -9.8 to -0.2; P=0.040).Conclusion: Hearing loss is associated with increased propofol sensitivity in vestibular schwannoma surgery, highlighting its potential relevance in anesthesia management.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Addressing Methodological and Clinical Aspects of the Scalp Nerve Block Study By Choi et al. 解决头皮神经阻滞研究的方法学和临床问题。

IF 2.4 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-07-31 DOI: 10.1097/ANA.0000000000001053

Tanushree Mohan, Ajay P Hrishi, Manikandan Sethuraman, Unnikrishnan Prathapadas

引用次数: 0

Detection of Venous Air Embolism in Nonsitting Craniotomy for Tumor Patients: A Retrospective Case Series. 肿瘤患者非坐位开颅术中静脉空气栓塞的检测：回顾性病例系列。

IF 2.4 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-07-31 DOI: 10.1097/ANA.0000000000001051

Gabrielle A White-Dzuro, Matthew R Smith, Allen Guo, Timothy West, Ariel L Mueller, Timothy Houle, Oluwaseun Akeju, Brian Nahed, James Rhee

{"title":"Detection of Venous Air Embolism in Nonsitting Craniotomy for Tumor Patients: A Retrospective Case Series.","authors":"Gabrielle A White-Dzuro, Matthew R Smith, Allen Guo, Timothy West, Ariel L Mueller, Timothy Houle, Oluwaseun Akeju, Brian Nahed, James Rhee","doi":"10.1097/ANA.0000000000001051","DOIUrl":"https://doi.org/10.1097/ANA.0000000000001051","url":null,"abstract":"Background: Venous air embolism (VAE) occurs when air enters the venous circulation. During nonsitting craniotomies with elevated VAE risk due to proximity to a venous sinus, our institutional practice is to employ precordial Doppler ultrasound (PDU) and transesophageal echocardiography (TEE) for monitoring, as well as central venous catheterization (CVC) for aspiration. We utilized an electronic medical record (EMR) database to assess the frequency of VAE occurrence, its clinical detection, and the use of VAE-specific monitoring modalities.Methods: EMR review identified all patients who underwent nonsitting craniotomies for an intracranial tumor. To identify episodes of VAE occurrence, the EMR was screened for intraoperative VAE events as determined by clinical diagnosis (cVAE) as well as an EtCO2 drop >20% over a 2-minute interval, concerning for suspected VAE (sVAE). To identify patients who had VAE-specific monitoring, the EMR was scanned for placement of a CVC, TEE, or PDU.Results: Three thousand nine hundred forty-five patients underwent a craniotomy for resection of tumor, and 3531 met study inclusion criteria. There were 14 episodes of intraoperative VAE diagnosed by a clinician (cVAE) and 86 episodes of suspected VAE (sVAE) based on review of anesthesia records for significant changes in EtCO2. There were 261 cases that used VAE-specific monitoring, with minimal overlap with sVAE cases.Conclusions: We identified 100 episodes of VAE, diagnosed either clinically (cVAE) or by abrupt EtCO2 decrease (sVAE). Our data suggest that VAE in nonsitting craniotomy often occurs in instances where VAE-specific monitoring modalities are not used, and that our ability to preoperatively identify neurosurgical cases where VAE may occur is limited.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Looks Can Be Deceiving: Prevalence of Burst Suppression During Liver Transplantation Surgery. 外表可能具有欺骗性：肝移植手术中爆发抑制的流行。

IF 2.4 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-07-30 DOI: 10.1097/ANA.0000000000001048

Anna M Nuti, Marielle Sakr, Shobana Rajan

引用次数: 0

Factors Associated With Prolonged Hospital Stay After Craniotomy for Tumor: A Single Center Quality Improvement Study. 肿瘤开颅术后延长住院时间的相关因素：一项单中心质量改善研究

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-07-07 DOI: 10.1097/ANA.0000000000001050

Martin Kryspin Sørensen, Alexandra Vassilieva, Mira Søgaard Jørgensen, Jane Skjøth-Rasmussen, Pernille Vinding Hansen, Nana Askjær-Friis, Lisette Willumsen, Dorte Aldershvile, Tenna Bach Damhøj, Louise Corneliussen Rughave, Markus Harboe Olsen, Torstein R Meling, Henrik Kehlet

引用次数: 0

Temporary Intraoperative Cerebral Blood Flow Reduction to Facilitate Neurovascular Procedures. 术中临时减少脑血流以促进神经血管手术。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-07-04 DOI: 10.1097/ANA.0000000000001046

Adele S Budiansky, Tomasz Polis, Kan Ma

{"title":"Temporary Intraoperative Cerebral Blood Flow Reduction to Facilitate Neurovascular Procedures.","authors":"Adele S Budiansky, Tomasz Polis, Kan Ma","doi":"10.1097/ANA.0000000000001046","DOIUrl":"https://doi.org/10.1097/ANA.0000000000001046","url":null,"abstract":"Temporary blood flow reduction is essential in the management of complex neurovascular lesions in both open and endovascular settings. This focused review examines the four principal techniques commonly used to achieve flow reduction for neurovascular procedures. Deep hypothermic circulatory arrest (DHCA) has largely become obsolete in recent years due to significant perioperative morbidity and the emergence of less invasive flow reduction strategies. Intravenous adenosine remains a popular option since it is readily available in the perioperative setting, though the hemodynamic response may be unpredictable because of interindividual dose-response variability. Rapid ventricular pacing (RVP) provides controlled, predictable flow reduction but requires advanced procedural planning. Endovascular balloon-assisted occlusion provides localized control in anatomically challenging areas under a hybrid neurosurgical-endovascular approach. To date, no single technique has demonstrated superiority over another, and the optimal strategy should be individualized based on lesion characteristics, institutional expertise, and available resources. Future research should focus on potential neuroprotective strategies during flow reduction and further characterize the safety and efficacy profiles of various flow reduction techniques through prospective cohort studies.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Perioperative Management of Anticoagulant and Antiplatelet Therapy in Elective Neurosurgery Patients: A Narrative Review. 择期神经外科患者抗凝和抗血小板治疗的围手术期管理：叙述性回顾。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-07-04 DOI: 10.1097/ANA.0000000000001047

Carolina Iaquaniello, Emanuela Scordo, Marco Gemma, Vanessa Agostini, Alessandro Bertuccio, Chiara Robba

{"title":"Perioperative Management of Anticoagulant and Antiplatelet Therapy in Elective Neurosurgery Patients: A Narrative Review.","authors":"Carolina Iaquaniello, Emanuela Scordo, Marco Gemma, Vanessa Agostini, Alessandro Bertuccio, Chiara Robba","doi":"10.1097/ANA.0000000000001047","DOIUrl":"https://doi.org/10.1097/ANA.0000000000001047","url":null,"abstract":"Antiplatelet and anticoagulant medications are widely prescribed to the general population for therapeutic and prophylactic purposes in a wide range of diseases, mainly of cardiovascular interest, spanning from acute events such as acute coronary syndromes (ACS), strokes, and thromboembolic disorders to chronic conditions like atrial fibrillation (AF) and peripheral vascular diseases. The management of such therapies is expected to escalate over time due to the aging population, which has a growing need for these medications, and the rising demand for surgical procedures. The management of anticoagulants and antiplatelets still represents a tough challenge for clinicians in elective neurosurgical procedures, where the balance between preventing thromboembolic events and an increased bleeding risk plays a crucial role in all phases of the perioperative setting. Managing antiplatelet and anticoagulant drugs in elective neurosurgery is complex and requires a tailored and multidisciplinary approach. Careful assessment of patient factors, surgery type, and potential risks and benefits is essential. POC testing can be valuable in optimizing therapy management and bleeding risk assessment. This narrative review for clinicians aims to provide an updated overview of the management of these drugs in the perioperative setting of elective neurosurgical procedures. We explored coagulation abnormalities commonly found in neurosurgical patients, the pharmacological profile of each class of drugs, the appropriate management according to the type of procedure (brain or spinal), and the available diagnostic tests, focusing on the application of point-of-care (POC) coagulation testing.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of Volatile Versus Intravenous Anesthesia on Cerebral Vasospasm in Open Surgical and Endovascular Procedures for Aneurysmal Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis. 挥发性麻醉与静脉麻醉对动脉瘤性蛛网膜下腔出血开放手术和血管内手术中脑血管痉挛的影响：一项系统综述和荟萃分析

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-07-02 DOI: 10.1097/ANA.0000000000001049

Shuo Wang, Quanshui Hao, Rao Sun, Haiting Wang, Ping Zhang, Wei Mei

{"title":"Effects of Volatile Versus Intravenous Anesthesia on Cerebral Vasospasm in Open Surgical and Endovascular Procedures for Aneurysmal Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis.","authors":"Shuo Wang, Quanshui Hao, Rao Sun, Haiting Wang, Ping Zhang, Wei Mei","doi":"10.1097/ANA.0000000000001049","DOIUrl":"https://doi.org/10.1097/ANA.0000000000001049","url":null,"abstract":"The selection of anesthetic agents during aneurysm repair may have an impact on the prognosis of patients with aneurysmal subarachnoid hemorrhage (SAH). In this systematic review and meta-analysis, we compared the effects of volatile-based anesthesia with those of total intravenous anesthesia (TIVA) on perioperative outcomes in SAH patients. A comprehensive literature search was performed in PubMed, EMBASE, Web of Science, and the Cochrane Library through December 2024, yielding 9 studies (comprising 4 randomized controlled trials [RCTs] and 5 cohort studies) with a total of 1459 participants. Data pooled from the cohort studies indicated that volatile-based anesthesia was associated with a lower risk of postoperative cerebral vasospasm (risk ratio [RR]=0.72; 95% CI: 0.62-0.83; I2=22%) and delayed cerebral ischemia (RR=0.63; 95% CI: 0.51-0.80; I2=22%). In contrast, analyses of the RCTs showed no significant differences between the 2 anesthetic techniques regarding cerebral vasospasm (RR=1.04; 95% CI: 0.35-3.06; I2=60%), infarction (RR=1.51; 95% CI: 0.76-3.00; I2=0%), or intraoperative brain swelling (RR=1.14; 95% CI: 0.83-1.58; I2=0%). The Egger regression test did not reveal any evidence of publication bias. Overall, these findings suggest that although cohort studies point to a potential benefit of volatile-based anesthesia in reducing the incidence of postoperative vasospasm and delayed cerebral ischemia, the pooled results from RCTs do not corroborate these differences. Thus, further large-scale, high-quality randomized trials are warranted to better elucidate the comparative effects of these anesthetic approaches in aneurysmal SAH repair procedures.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Representation of Authors From Low and Middle-income Countries in 2 Neuroanesthesiology and Neurocritical Care Journals: A Retrospective Analysis. 来自低收入和中等收入国家的作者在两种神经麻醉学和神经危重症期刊上的代表性：回顾性分析。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-07-01 Epub Date: 2024-12-30 DOI: 10.1097/ANA.0000000000001017

Chandini Kukanti, Indu Kapoor, Charu Mahajan, Hemanshu Prabhakar

引用次数: 0

Enhanced Recovery After Surgery for Patients Undergoing Craniotomy Still Needs Affirmation! 开颅手术患者术后恢复增强仍需肯定！

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-07-01 Epub Date: 2025-02-18 DOI: 10.1097/ANA.0000000000001032

Indu Kapoor, Charu Mahajan, Hemanshu Prabhakar

引用次数: 0