Journal of neurosurgical anesthesiology最新文献

{"title":"Regional Anesthesia Techniques in Modern Neuroanesthesia Practice: A Narrative Review of the Clinical Evidence.","authors":"Kan Ma, Jamie L Uejima, John F Bebawy","doi":"10.1097/ANA.0000000000000911","DOIUrl":"10.1097/ANA.0000000000000911","url":null,"abstract":"<p><p>Neurosurgical procedures are often associated with significant postoperative pain that is both underrecognized and undertreated. Given the potentially undesirable side effects associated with general anesthesia and with various pharmacological analgesic regimens, regional anesthetic techniques have gained in popularity as alternatives for providing both anesthesia and analgesia for the neurosurgical patient. The aim of this narrative review is to present an overview of the regional techniques that have been incorporated and continue to be incorporated into modern neuroanesthesia practice, presenting in a comprehensive way the evidence, where available, in support of such practice for the neurosurgical patient.</p>","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"109-118"},"PeriodicalIF":3.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9500445","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":"Modified Thoracolumbar Interfascial Plane Block Versus Erector Spinae Plane Block in Patients Undergoing Spine Surgeries: A Randomized Controlled Trial.","authors":"Amarjeet Kumar, Chandni Sinha, Ajeet Kumar, Poonam Kumari, Abhyuday Kumar, Prabhat Agrawal, Chethan Vamshi","doi":"10.1097/ANA.0000000000000900","DOIUrl":"10.1097/ANA.0000000000000900","url":null,"abstract":"<p><strong>Background: </strong>Lumbar spine surgery is associated with significant postoperative pain. Interfascial plane blocks, such as erector spinae plane (ESP) and thoracolumbar interfascial plane (TLIP) blocks, can play a significant role in multimodal analgesic regimens.</p><p><strong>Methods: </strong>Sixty patients aged 18 to 60 years undergoing elective single or double-level lumbar discectomy or primary lumbar laminoplasty were recruited into this randomized double‑blind study. All patients received general anesthesia and were randomly allocated to either modified TLIP (mTLIP) block (group M) or ESP block (group E). Postoperative and intraoperative fentanyl consumption, and postoperative pain scores, were recorded.</p><p><strong>Results: </strong>Total 48 h postoperative fentanyl consumption was higher in Group M (189.66±141.11 µg) than in Group E (124.16±80.83 µg; P =0.031). In the first 24 postoperative hours, fentanyl consumption was higher in Group M (150.3±120.9 µg) than in group E (89.9±65.3 µg; P =0.01) but was similar between groups in postoperative hours 24to 48 (39.0±20.2 µg versus 34.7±17.1 µg in group M and group E, respectively; P =0.37). Additional intraoperative fentanyl requirement was 57.66±21.76 µg in group M compared with 40.33±21.89 µg in group E ( P <0.01). Postoperative pain scores were higher in group M than in group E at 1, 2, 4, 6, 12, and 24 hours postoperatively ( P <0.001), but similar at 48 hours ( P =0.164).</p><p><strong>Conclusion: </strong>Compared with the mTLIP block, the ESP block was associated with lower pain scores and a small decrease in perioperative fentanyl consumption in patients undergoing lumbar spine surgeries. Both blocks could form a part of a multimodal analgesic regimen in spine surgery patients.</p>","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"119-124"},"PeriodicalIF":3.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10607623","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":"Effect of Repeated Exposure to Sevoflurane on Electroencephalographic Alpha Oscillation in Pediatric Patients Undergoing Radiation Therapy: A Prospective Observational Study.","authors":"Samuel Madariaga, Christ Devia, Antonello Penna, José I Egaña, Vanessa Lucero, Soledad Ramírez, Felipe Maldonado, Macarena Ganga, Nicolás Valls, Nicolás Villablanca, Tomás Stamm, Patrick L Purdon, Rodrigo Gutiérrez","doi":"10.1097/ANA.0000000000000938","DOIUrl":"10.1097/ANA.0000000000000938","url":null,"abstract":"<p><strong>Background: </strong>Pharmacological tolerance is defined as a decrease in the effect of a drug over time, or the need to increase the dose to achieve the same effect. It has not been established whether repeated exposure to sevoflurane induces tolerance in children.</p><p><strong>Methods: </strong>We conducted an observational study in children younger than 6 years of age scheduled for multiple radiotherapy sessions with sevoflurane anesthesia. To evaluate the development of sevoflurane tolerance, we analyzed changes in electroencephalographic spectral power at induction, across sessions. We fitted individual and group-level linear regression models to evaluate the correlation between the outcomes and sessions. In addition, a linear mixed-effect model was used to evaluate the association between radiotherapy sessions and outcomes.</p><p><strong>Results: </strong>Eighteen children were included and the median number of radiotherapy sessions per child was 28 (interquartile range: 10 to 33). There was no correlation between induction time and radiotherapy sessions. At the group level, the linear mixed-effect model showed, in a subgroup of patients, that alpha relative power and spectral edge frequency 95 were inversely correlated with the number of anesthesia sessions. Nonetheless, this subgroup did not differ from the other subjects in terms of age, sex, or the total number of radiotherapy sessions.</p><p><strong>Conclusions: </strong>Our results suggest that children undergoing repeated anesthesia exposure for radiotherapy do not develop tolerance to sevoflurane. However, we found that a group of patients exhibited a reduction in the alpha relative power as a function of anesthetic exposure. These results may have implications that justify further studies.</p>","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"125-133"},"PeriodicalIF":3.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107591479","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":"Analgesic Effects of Preoperative Combination of Oral Pregabalin and Intravenous Magnesium Sulfate on Postoperative Pain in Patients Undergoing Posterolateral Spinal Fusion Surgery: A 4-arm, Randomized, Double-blind, Placebo-controlled Trial.","authors":"Roozbeh Tavanaei, Seyyed S Rezaee-Naserabad, Sajjad Alizadeh, Kaveh O Yazdani, Alireza Zali, Hamidreza A Farsani, Saeed Oraee-Yazdani","doi":"10.1097/ANA.0000000000000893","DOIUrl":"10.1097/ANA.0000000000000893","url":null,"abstract":"<p><strong>Background: </strong>Multimodal perioperative pain management including nonopioid analgesia is a major pillar of enhanced recovery after surgery programs. The aim of this study was to investigate the analgesic efficacy of the preoperative combination of 2 nonopioid drugs, oral pregabalin and intravenous magnesium sulfate, in patients undergoing posterolateral lumbar spinal fusion.</p><p><strong>Methods: </strong>This 4-arm, randomized, double-blind, placebo-controlled trial included 104 patients randomly allocated to receive: magnesium sulfate and pregabalin (MP), magnesium sulfate and oral placebo (M), 0.9% saline and oral pregabalin (P), and 0.9% saline and oral placebo (C). The study drugs were administered 1 hour preoperatively. The primary outcome was the cumulative morphine consumption on postoperative day 1. Secondary outcomes included visual analog scale scores for leg pain at rest and with movement, and postoperative nausea and vomiting (PONV) in the first 48 hours after surgery.</p><p><strong>Results: </strong>Cumulative morphine consumption on postoperative day 1 was lower in group MP (19.6±8.0 mg) compared with group M (32.6±9.5 mg; P <0.001), group P (28.9±9.4 mg; P =0.001), or group C (38.8±10.3 mg; P <0.001). Multiple linear regression demonstrated a significant association between group MP and cumulative morphine consumption (B=-5.4 [95% CI, -7.1, -3.7], P <0.001). Visual analog scale scores for leg pain at rest and with movement were lower in group MP compared with other groups ( P =0.006 and <0.001). The incidence of PONV was also lowest in group MP ( P =0.032).</p><p><strong>Conclusions: </strong>Preoperative administration of oral pregabalin and intravenous magnesium sulfate resulted in reduced morphine consumption and greater analgesic effect than the use of each drug individually or placebo in patients undergoing posterolateral lumbar spinal fusion.</p>","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"134-141"},"PeriodicalIF":3.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10638494","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":"Fluid Balance and Hemodynamic Monitoring of Traumatic Brain Injured Patients: An International Survey.","authors":"Chiara Robba, Mathieu van der Jagt, Fabio Taccone, Giuseppe Citerio, Antonio Messina","doi":"10.1097/ANA.0000000000000925","DOIUrl":"10.1097/ANA.0000000000000925","url":null,"abstract":"","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"177-179"},"PeriodicalIF":3.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10005881","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":"Management of Cardiopulmonary Resuscitation in Patients Undergoing Intracranial Surgery Using Pin-type Head Clamps: A 12-years Retrospective Study.","authors":"Emmanuel Schneck, Dominik Leicht, Michael Bender, Marco Stein, Eberhard Uhl, Michael Sander, Christian Koch","doi":"10.1097/ANA.0000000000000898","DOIUrl":"10.1097/ANA.0000000000000898","url":null,"abstract":"","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"172-173"},"PeriodicalIF":3.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9152637","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":"Ultrasound-guided Greater Occipital Nerve Block in Children Undergoing Posterior Fossa Craniotomy: A Randomized, Controlled Trial.","authors":"Heba Nassar, Khaled Sarhan, Maha Gamil, Manal Elgohary, Hany El-Hadi, Sahar Mahmoud","doi":"10.1097/ANA.0000000000000899","DOIUrl":"10.1097/ANA.0000000000000899","url":null,"abstract":"<p><strong>Background: </strong>Posterior fossa surgery is commonly associated with severe postoperative pain. This study assessed the impact of ultrasound-guided greater occipital nerve (GON) block on postoperative pain and hemodynamic profiles in pediatric posterior fossa craniotomy.</p><p><strong>Materials and methods: </strong>Children aged 2 to 12 years undergoing elective posterior fossa craniotomy with general anesthesia were randomly allocated to a control group receiving standard care (n=18) or a GON block group receiving standard care plus bilateral ultrasound-guided GON block (=17). Outcomes were postoperative pain assessed using the objective pain scale, time to first postoperative analgesia, intraoperative fentanyl consumption, perioperative blood pressure and heart rate, incidence of nausea and vomiting, and nerve-block-related complications.</p><p><strong>Results: </strong>Objective pain scale scores were lower in the GON block group than in the control group at 2, 4, 6, 8 (all P =0.0001), 12 ( P =0.001), 16 ( P =0.03), and 24-hour ( P =0.004) postoperatively. The time to first analgesic request was 13.4±7.4 hours in the GON block group and 1.8±1.5 hours in the control group ( P <0.001). Intraoperative fentanyl consumption was 2.68±0.53 μg/kg -1 in the GON block group and 4.1±0.53 μg/kg -1 in the control group ( P =0.0001). Systolic blood pressure was lower in the GON block group at several intraoperative and postoperative time points, whereas heart rate was similar in the two groups at most time points. The incidence of postoperative nausea and vomiting was similar between groups ( P =0.38), and there were no nerve-block-related complications.</p><p><strong>Conclusions: </strong>In children undergoing posterior fossa craniotomy, GON block was associated with superior quality and duration of postoperative analgesia and better hemodynamic profile compared with standard care.</p>","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"159-163"},"PeriodicalIF":3.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10607624","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":"A High Immediate Postoperative Neutrophil-to-Albumin Ratio is Associated With Unfavorable Clinical Outcomes at Hospital Discharge in Patients With Aneurysmal Subarachnoid Hemorrhage.","authors":"Kyung Won Shin, Seungeun Choi, Hyongmin Oh, So Yeong Hwang, Hee-Pyoung Park","doi":"10.1097/ANA.0000000000000906","DOIUrl":"10.1097/ANA.0000000000000906","url":null,"abstract":"<p><strong>Background: </strong>Inflammation is associated with unfavorable clinical outcomes after aneurysmal subarachnoid hemorrhage (aSAH). We evaluated the relationship between postoperative neutrophil-to-albumin ratio (NAR) and unfavorable clinical outcomes (modified Rankin score ≥ 3) at hospital discharge in aSAH patients.</p><p><strong>Methods: </strong>Five hundred sixty aSAH patients undergoing surgical or endovascular treatment were included in this retrospective study. Patients were initially allocated to high (n=247) or low (n=313) postoperative NAR groups based on the immediate postoperative NAR cutoff value identified by receiver operating characteristic analysis, and then further subclassified into 4 groups: HH (high pre- and high postoperative NAR, n=156), LH (low preoperative and high postoperative NAR, n=91), HL (high preoperative and low postoperative NAR, n=68), and low pre- and low postoperative NAR (n=245).</p><p><strong>Results: </strong>Optimum cutoff values of immediate postoperative and preoperative NAR were 2.45 and 2.09, respectively. Unfavorable clinical outcomes were more frequent in patients with high compared with low postoperative NAR (45.3% vs. 13.4%; P < 0.001). In multivariate analysis, postoperative NAR was a significant predictor of unfavorable clinical outcomes (odds ratio, 2.10; 95% CI, 1.42-3.10; P < 0.001). Unfavorable clinical outcomes were less frequent in group low pre- and low postoperative NAR than in groups HH, LH, and HL (9.4% vs. 44.9%, 46.2% and 27.9%, respectively; all P < 0.001) and also in Group HL compared with groups HH and LH ( P =0.026 and P =0.030); clinical outcomes did not differ between Groups HH and LH.</p><p><strong>Conclusions: </strong>A high immediate postoperative NAR was associated with unfavorable clinical outcomes at hospital discharge in aSAH patients.</p>","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"142-149"},"PeriodicalIF":3.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10731440","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":"Differential Indirect Effects of Military Sexual Trauma on Posttraumatic Stress Disorder Symptom Clusters via Past-Year Intimate Partner Violence Experiences.","authors":"Colin T Mahoney, Danielle R Shayani, Katherine M Iverson","doi":"10.1037/trm0000242","DOIUrl":"10.1037/trm0000242","url":null,"abstract":"<p><p>Women who serve in the military are at high risk for experiencing military sexual trauma (MST) and intimate partner violence (IPV), both of which are associated with symptoms of posttraumatic stress disorder (PTSD). To improve understanding of the psychological effects of experiencing multiple forms of interpersonal violence, it is important to identify the ways in which recent IPV experiences differentially increase the risk of specific PTSD symptom clusters for women with a history of MST. We aimed to identify if past-year IPV experiences mediate the relation between MST experiences and PTSD symptom clusters (i.e., intrusions, avoidance, negative alterations in cognitions/mood, hyperarousal) using structural equation modeling. A mail survey was administered to a sample of US female veterans at two time points 12 months apart. Among 198 participants, 108 women (54.5%) reported MST at Time 1, and 73 women (36.9%) reported IPV experiences in the past year at Time 2. PTSD symptom severity ranged from asymptomatic to beyond the diagnostic cutoff for a probable PTSD diagnosis. Past-year IPV experiences significantly mediated the association between MST history and PTSD avoidance symptoms, and MST history and PTSD negative alterations in cognitive/mood symptoms. No significant mediating effect was found for intrusion symptoms or hyperarousal symptoms. These findings can inform evidence-based practices for appropriate screening, assessment, detection, and intervention, including primary and secondary prevention efforts to instrumentally reduce future experiences of violence for female survivors of interpersonal violence.</p>","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":"5 1","pages":"17-26"},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11136477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83620635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment and Recommendations for Website Platforms of Neuroanesthesiology Fellowship Programs.","authors":"Vladislav P Zhitny, Kenny Do, Eric Kawana, Jenifer Do, Michael C Wajda, Jose Gallegos, Kyle Carey, Geoff Yee, Lauren C Hollifield, Arturo Montes, Edward Walton, Shah Ahmed","doi":"10.1097/ANA.0000000000000958","DOIUrl":"10.1097/ANA.0000000000000958","url":null,"abstract":"<p><strong>Background: </strong>Websites serve as recruitment and educational tools for many fellowship programs, including neuroanesthesiology. Since the COVID-19 pandemic, when interviews, conferences, and institutional visits were moved online, websites have become more important for applicants when deciding on their preferred fellowship program. This study evaluated the content of the websites of neuroanesthesiology fellowship programs.</p><p><strong>Methods: </strong>Neuroanesthesiology fellowship program websites were identified from the websites of the International Council on Perioperative Neuroscience Training and the Society for Neuroscience in Anesthesiology and Critical Care. The content was assessed against 24 predefined criteria.</p><p><strong>Results: </strong>Fifty-three fellowship programs were identified, of which 42 websites were accessible through a Google search and available for evaluation. The mean number of criteria met by the 42 fellowship websites was 12/24 (50%), with a range of 6 to 18 criteria. None of the evaluated fellowship websites met all 24 predefined criteria; 20 included more than 50% of the criteria, whereas 7 included fewer than 30% of the criteria. Having a functional website, accessibility through a single click from Google, and a detailed description of the fellowship program were the features of most websites. Information about salary and life in the area, concise program summaries, and biographical information of past and current fellows were missing from a majority of websites.</p><p><strong>Conclusion: </strong>Important information was missing from most of the 42 evaluated neuroanesthesiology fellowship program websites, potentially hindering applicants from making informed choices about their career plans.</p>","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139735453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}