Journal of neurosurgical anesthesiology最新文献

{"title":"Beyond Implementation: Neuroanesthesiologists as Artificial Intelligence CoCreators.","authors":"Meredith C B Adams","doi":"10.1097/ANA.0000000000001113","DOIUrl":"https://doi.org/10.1097/ANA.0000000000001113","url":null,"abstract":"","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674129","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}

{"title":"Phase-Specific Electroencephalography Monitoring: A Dynamic Approach to Predict Postoperative Delirium During Aortic Surgery.","authors":"Young Song, Hye S Lee, Dong W Han, Sujung Park, Sang B Nam, Hyejin Yang, Jayyoung Bae","doi":"10.1097/ANA.0000000000001111","DOIUrl":"https://doi.org/10.1097/ANA.0000000000001111","url":null,"abstract":"<p><strong>Background: </strong>Static or averaged electroencephalography (EEG) metrics may fail to capture dynamic cerebral changes during surgery. We assessed the EEG features during aortic arch surgery with cardiopulmonary bypass (CPB) and total circulatory arrest (TCA) to identify key EEG predictors of postoperative delirium (POD).</p><p><strong>Methods: </strong>This retrospective study analyzed intraoperative EEG data from 233 patients across 5 phases: pre-CPB, CPB initiation, TCA, post-TCA, and post-CPB. The predictive potential of EEG parameters was assessed using logistic regression, and phase-specific nomogram models were developed. The primary analysis included emergency cases; elective cases were included in sensitivity analyses.</p><p><strong>Results: </strong>POD occurred in 78 patients (44.8%). Phase-specific models showed high predictive performance. Independent predictors of POD included reduced alpha power during the post-CPB phase (odds ratio [OR]=0.76, 95% CI: 0.67-0.87, P<0.001) and lower delta power during TCA (OR=0.87, 95% CI: 0.79-0.96, P=0.031). In addition, elevated BSR during CPB initiation (OR=1.53, 95% CI: 1.24-1.89, P<0.001) and post-TCA (OR=1.37, 95% CI: 1.11-1.70, P=0.008) predicted increased POD incidence. A similar, but nonsignificant, observation for alpha power was observed during the pre-CPB phase (P=0.103). Calibration plots showed strong agreement between predicted and observed outcomes.</p><p><strong>Conclusions: </strong>Phase-specific EEG monitoring reliably predicted POD during aortic arch surgery. Predictive factors varied across intraoperative phases, underscoring the dynamic sensitivity of EEG to physiological changes. Comprehensive, phase-specific EEG assessment may improve risk stratification and perioperative management, though large prospective studies are needed to confirm these findings.</p>","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674171","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}

{"title":"Beyond U-Shaped Curves: Intracranial Severity and Mechanisms Behind Preinduction Blood Pressure Signals.","authors":"Ya-Ying Chang, Cheng-Wei Lu","doi":"10.1097/ANA.0000000000001115","DOIUrl":"https://doi.org/10.1097/ANA.0000000000001115","url":null,"abstract":"","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674150","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}

{"title":"Association Between Intraoperative Fluid Therapy and Postoperative Complications in Posterior Fossa Surgery: A Retrospective Analysis of Vestibular Schwannoma Resections in the Semi-sitting Position.","authors":"Dzmitry Kuzmin, Iván N Camal Ruggieri, Daniel Staribacher, Guenther C Feigl","doi":"10.1097/ANA.0000000000001100","DOIUrl":"10.1097/ANA.0000000000001100","url":null,"abstract":"","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674140","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}

{"title":"Beyond Feasibility: A Critical Appraisal of Wearable-Based Vital Sign Monitoring on a Neurosurgical Ward.","authors":"Muhammad Rafay Shahzad Cheema","doi":"10.1097/ANA.0000000000001112","DOIUrl":"https://doi.org/10.1097/ANA.0000000000001112","url":null,"abstract":"","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623171","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}

{"title":"The Study Protocol Is Key for Assessing the Influence of Regional Block on Quality of Recovery After Spinal Surgery.","authors":"Fu-Shan Xue, Dan-Feng Wang, Yan-Hua Guo","doi":"10.1097/ANA.0000000000001083","DOIUrl":"10.1097/ANA.0000000000001083","url":null,"abstract":"","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"187"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145970864","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}

{"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":"10.1097/ANA.0000000000001049","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"115-123"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","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}

{"title":"General Anesthesia Versus Conscious Sedation for Endovascular Thrombectomy in Patients With Acute Ischemic Stroke: Updated Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Thomas Francis, Rajeeb Kumar Mishra, Kamath Sriganesh, Dhritiman Chakrabarti, Prasad Nagesh Nagamangala","doi":"10.1097/ANA.0000000000001110","DOIUrl":"https://doi.org/10.1097/ANA.0000000000001110","url":null,"abstract":"<p><p>The optimal anesthetic technique during endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) remains uncertain. General anesthesia (GA) provides airway protection and procedural stability, whereas conscious sedation (CS) offers faster workflow and the ability to monitor neurological status. This updated systematic review and meta-analysis (SRMA) aims to summarize and update the existing literature from randomized controlled trials (RCTs) to guide the selection of the most appropriate anesthetic technique during EVT for AIS. We searched the electronic databases of PubMed, ProQuest, and Scopus from their inception to October 17, 2025. No time or language restrictions were applied. Only RCTs were included. The SRMA protocol was registered with PROSPERO (ID: CRD420251170612) on 18th October 2025. Statistical analysis was performed using Review Manager software. Risk of bias (RoB) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were assessed. Of the 348 records screened, ten eligible RCTs were included. GA was associated with a significantly higher rate of successful reperfusion, but there was no difference in 90-day functional independence on modified Rankin scale (mRS) score, or mortality compared with CS. GA increased the risk of hypotension and prolonged the door-to-puncture time, but not other complications or process times. The RoB was low for most included studies. The certainty of evidence for study outcomes was moderate on GRADE. To conclude, GA has superior recanalization rates than CS, but functional outcomes and mortality are similar. Conversely, hypotension occurs more frequently with GA, while CS provides a faster workflow.</p>","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592838","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}

{"title":"Impact of Intraoperative Hypotension and Blood Loss on Brain Damage Biomarkers in Metopic Craniosynostosis Surgery.","authors":"Ingrid Stubelius, Christopher Lundborg, Martin Thorsson, Isak Michaëlsson, Thomas Skoglund, Tobias Hallén, Peter Tarnow, Henrik Zetterberg, Kaj Blennow, Lars Kölby","doi":"10.1097/ANA.0000000000001057","DOIUrl":"10.1097/ANA.0000000000001057","url":null,"abstract":"<p><strong>Background: </strong>Recent studies show that levels of the brain injury biomarkers glial fibrillary acidic protein (GFAP) and neurofilament light (NfL) are elevated postoperatively in infants undergoing surgery for craniosynostosis. The aim of this study was to investigate the relationship between intraoperative hypotension and blood loss on biomarker levels.</p><p><strong>Methods: </strong>This retrospective study included all consecutive patients undergoing surgery for metopic synostosis at our institution from January 2019 to September 2020 who were included in a previous trial. We extracted data from the medical record on intraoperative blood pressure, heart rate, and intraoperative blood loss. Pre- and postoperative GFAP and NfL levels were measured in stored blood samples. Hypotension was defined as the area under the curve (AUC) of mean arterial blood pressure (MAP) at 4 threshold levels (35, 40, 45, and 50 mm Hg, respectively). This AUC and intraoperative blood loss were used to identify correlations with postoperative changes in baseline GFAP and NfL levels.</p><p><strong>Results: </strong>A total of 20 patients [age: 190±65 d (mean±SD); and weight: 8.0±1.0 kg] undergoing an open cranial vault procedure for metopic synostosis repair were included. Intraoperative blood loss was 27±11 mL/kg, and we did not identify significant association between plasma NfL or GFAP level and any MAP threshold (NfL AUC40 rs =0.08, AUC45 rs =0.15, AUC50 rs =0.30. GFAP AUC40 rs =-0.17, AUC45 rs =0.01, AUC50 rs =-0.06) or blood loss parameter [NfL rs =0.26, GFAP rs =-0.15].</p><p><strong>Conclusion: </strong>We did not identify a relationship between MAP, blood loss, and markers of brain injury. Our findings suggest that other factors (eg, mechanical manipulation) may explain the observed elevations in brain injury biomarkers after craniosynostosis surgery. This study is limited by its sample size and further investigation is needed.</p>","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"124-131"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957586","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}

{"title":"Volatile Anesthetics in Subarachnoid Hemorrhage-related Vasospasm: Protective or Not?","authors":"Hemant Bhagat","doi":"10.1097/ANA.0000000000001082","DOIUrl":"https://doi.org/10.1097/ANA.0000000000001082","url":null,"abstract":"","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":"38 2","pages":"95-97"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348449","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}