Journal of neurosurgical anesthesiology最新文献_第3页

Differences in Perioperative Management of Patients Undergoing Complex Spine Surgery: A Global Perspective. 复杂脊柱手术患者围手术期管理的差异：全球视角。

IF 3.7 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2024-07-01 Epub Date: 2023-05-16 DOI: 10.1097/ANA.0000000000000919

Samuel N Blacker, Nathan Woody, Ananya Abate Shiferaw, Mark Burbridge, Maria A Bustillo, Sprague W Hazard, Benjamin J Heller, Massimo Lamperti, Jorge Mejia-Mantilla, Jacob W Nadler, Girija Prasad Rath, Chiara Robba, Anita Vincent, Azarias K Admasu, Meron Awraris, Abhijit V Lele

{"title":"Differences in Perioperative Management of Patients Undergoing Complex Spine Surgery: A Global Perspective.","authors":"Samuel N Blacker, Nathan Woody, Ananya Abate Shiferaw, Mark Burbridge, Maria A Bustillo, Sprague W Hazard, Benjamin J Heller, Massimo Lamperti, Jorge Mejia-Mantilla, Jacob W Nadler, Girija Prasad Rath, Chiara Robba, Anita Vincent, Azarias K Admasu, Meron Awraris, Abhijit V Lele","doi":"10.1097/ANA.0000000000000919","DOIUrl":"10.1097/ANA.0000000000000919","url":null,"abstract":"Background: The aim of this survey was to understand institutional spine surgery practices and their concordance with published best practices/recommendations.Methods: Using a global internet-based survey examining perioperative spine surgery practice, reported institutional spine pathway elements (n=139) were compared with the level of evidence published in guideline recommendations. The concordance of clinical practice with guidelines was categorized as poor (≤20%), fair (21%-40%), moderate (41%-60%), good (61%-80%), or very good (81%-100%).Results: Seventy-two of 409 (17.6%) institutional contacts started the survey, of which 31 (7.6%) completed the survey. Six (19.4%) of the completed surveys were from respondents in low/middle-income countries, and 25 (80.6%) were from respondents in high-income countries. Forty-one incomplete surveys were not included in the final analysis, as most were less than 40% complete. Five of 139 (3.6%) reported elements had very good concordance for the entire cohort; hospitals with spine surgery pathways reported 18 elements with very good concordance, whereas institutions without spine surgery pathways reported only 1 element with very good concordance. Reported spine pathways included between 7 and 47 separate pathway elements. There were 87 unique elements in the reviewed pathways. Only 3 of 87 (3.4%) elements with high-quality evidence demonstrated very good practice concordance.Conclusions: This global survey-based study identified practice variation and low adoption rates of high-quality evidence in the care of patients undergoing complex spine surgery.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"218-227"},"PeriodicalIF":3.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9847428","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

vCSF Danger-associated Molecular Patterns After Traumatic and Nontraumatic Acute Brain Injury: A Prospective Study. 创伤性和非创伤性急性脑损伤后 vCSF 危险相关分子模式：一项前瞻性研究

IF 3.7 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2024-07-01 Epub Date: 2023-04-27 DOI: 10.1097/ANA.0000000000000916

Carlos A Santacruz, Jean-Louis Vincent, Jorge Duitama, Edwin Bautista, Virginie Imbault, Michael Bruneau, Jacques Creteur, Serge Brimioulle, David Communi, Fabio S Taccone

{"title":"vCSF Danger-associated Molecular Patterns After Traumatic and Nontraumatic Acute Brain Injury: A Prospective Study.","authors":"Carlos A Santacruz, Jean-Louis Vincent, Jorge Duitama, Edwin Bautista, Virginie Imbault, Michael Bruneau, Jacques Creteur, Serge Brimioulle, David Communi, Fabio S Taccone","doi":"10.1097/ANA.0000000000000916","DOIUrl":"10.1097/ANA.0000000000000916","url":null,"abstract":"Background: Danger-associated molecular patterns (DAMPs) may be implicated in the pathophysiological pathways associated with an unfavorable outcome after acute brain injury (ABI).Methods: We collected samples of ventricular cerebrospinal fluid (vCSF) for 5 days in 50 consecutive patients at risk of intracranial hypertension after traumatic and nontraumatic ABI. Differences in vCSF protein expression over time were evaluated using linear models and selected for functional network analysis using the PANTHER and STRING databases. The primary exposure of interest was the type of brain injury (traumatic vs. nontraumatic), and the primary outcome was the vCSF expression of DAMPs. Secondary exposures of interest included the occurrence of intracranial pressure ≥20 or ≥ 30 mm Hg during the 5 days post-ABI, intensive care unit (ICU) mortality, and neurological outcome (assessed using the Glasgow Outcome Score) at 3 months post-ICU discharge. Secondary outcomes included associations of these exposures with the vCSF expression of DAMPs.Results: A network of 6 DAMPs ( DAMP_trauma ; protein-protein interaction [PPI] P =0.04) was differentially expressed in patients with ABI of traumatic origin compared with those with nontraumatic ABI. ABI patients with intracranial pressure ≥30 mm Hg differentially expressed a set of 38 DAMPS ( DAMP_ICP30 ; PPI P < 0.001). Proteins in DAMP_ICP30 are involved in cellular proteolysis, complement pathway activation, and post-translational modifications. There were no relationships between DAMP expression and ICU mortality or unfavorable versus favorable outcomes.Conclusions: Specific patterns of vCSF DAMP expression differentiated between traumatic and nontraumatic types of ABI and were associated with increased episodes of severe intracranial hypertension.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"252-257"},"PeriodicalIF":3.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9840656","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

Adding Ketamine to Epidural Morphine Does Not Prolong Postoperative Analgesia After Lumbar Laminectomy or Discectomy. 腰椎椎板切除术或椎间盘切除术后，在硬膜外吗啡中加入氯胺酮不会延长术后镇痛时间。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2024-07-01 Epub Date: 2023-03-29 DOI: 10.1097/ANA.0000000000000914

Prasadkanna Prabhakar, Ramamani Mariappan, Ranjith K Moorthy, Bijesh R Nair, Reka Karuppusami, Karen R Lionel

{"title":"Adding Ketamine to Epidural Morphine Does Not Prolong Postoperative Analgesia After Lumbar Laminectomy or Discectomy.","authors":"Prasadkanna Prabhakar, Ramamani Mariappan, Ranjith K Moorthy, Bijesh R Nair, Reka Karuppusami, Karen R Lionel","doi":"10.1097/ANA.0000000000000914","DOIUrl":"10.1097/ANA.0000000000000914","url":null,"abstract":"Background: Epidural opioids provide effective postoperative analgesia after lumbar spine surgery. Ketamine has been shown to reduce opioid-induced central sensitization and hyperalgesia. We hypothesized that adding ketamine to epidural opioids would prolong the duration of analgesia and enhance analgesic efficacy after lumbar spine surgery.Methods: American Society of Anesthesiologists physical status class I to II patients aged between 18 and 70 years with normal renal function undergoing lumbar laminectomy were recruited into this single-center randomized trial. Patients were randomized to receive either single-dose epidural morphine (group A) or epidural morphine and ketamine (group B) for postoperative analgesia. The primary objective was to compare the duration of analgesia as measured by time to the first postoperative analgesic request. Secondary objectives were the comparison of pain scores at rest and movement, systemic hemodynamics, and the incidence of side effects during the first 24 hours after surgery.Results: Fifty patients were recruited (25 in each group), of which data from 48 were available for analysis. The mean±SD duration of analgesia was 20±6 and 23±3 hours in group A and group B, respectively ( P =0.07). There were 12/24 (50%) patients in group A and 17/24 (71%) patients in group B who did not receive rescue analgesia during the first 24-hour postoperative period ( P =0.07). Pain scores at rest and movement, systemic hemodynamics, and postoperative complications were comparable between the groups.Conclusions: The addition of ketamine to epidural morphine did not prolong the duration of analgesia after lumbar laminectomy.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"244-251"},"PeriodicalIF":2.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9574688","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

Reply to Comment to the Editor "More Investigations Needed for Enhanced Recovery After Anesthesia for Craniotomy". 回复致编辑的评论 "开颅手术麻醉后需要更多研究以促进恢复"。

IF 3.7 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2024-07-01 Epub Date: 2024-05-06 DOI: 10.1097/ANA.0000000000000969

Sagar Jolly, Shashank Paliwal, Aditya Gadepalli, Sheena Chaudhary, Hemant Bhagat, Rafi Avitsian

引用次数: 0

Patient Positioning for Craniotomy in an Extracorporeal Membrane Oxygenation-supported Patient. 体外膜氧合患者开颅手术时的体位摆放。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2024-07-01 Epub Date: 2023-07-25 DOI: 10.1097/ANA.0000000000000931

Sagar Jolly, Gurjit Saini, Rafi Avitsian

引用次数: 0

Risk Factors for Postanesthetic Emergence Delirium in Adults: A Systematic Review and Meta-analysis. 成人麻醉后紧急谵妄的危险因素：系统综述和荟萃分析。

IF 3.7 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2024-07-01 Epub Date: 2023-11-02 DOI: 10.1097/ANA.0000000000000942

Miao He, Zhaoqiong Zhu, Min Jiang, Xingxing Liu, Rui Wu, Junjie Zhou, Xi Chen, Chengjiang Liu

{"title":"Risk Factors for Postanesthetic Emergence Delirium in Adults: A Systematic Review and Meta-analysis.","authors":"Miao He, Zhaoqiong Zhu, Min Jiang, Xingxing Liu, Rui Wu, Junjie Zhou, Xi Chen, Chengjiang Liu","doi":"10.1097/ANA.0000000000000942","DOIUrl":"10.1097/ANA.0000000000000942","url":null,"abstract":"Emergence delirium (ED) is delirium that occurs during or immediately after emergence from general anesthesia or sedation. Effective pharmacological treatments for ED are lacking, so preventive measures should be taken to minimize the risk of ED. However, the risk factors for ED in adults are unclear. In this systematic review and meta-analysis, we evaluated the evidence for risk factors for ED in adults. The PubMed, Scopus, Cochrane Library, Google Scholar, and Embase databases were searched for observational studies reporting the risk factors for ED in adults from inception to July 31, 2023. Twenty observational studies reporting 19,171 participants were included in this meta-analysis. Among the preoperative factors identified as risk factors for ED were age <40 or ≥65 years, male sex, smoking history, substance abuse, cognitive impairment, anxiety, and American Society of Anesthesiologists physical status score III or IV. Intraoperative risk factors for ED were the use of benzodiazepines, inhalational anesthetics, or etomidate, and surgical factors including abdominal surgery, frontal craniotomy (vs. other craniotomy approaches) for cerebral tumors, and the length of surgery. Postoperative risk factors were indwelling urinary catheters, the presence of a tracheal tube in the postanesthetic care unit or intensive care unit, the presence of a nasogastric tube, and pain. Knowledge of these risk factors may guide the implementation of stratified management and timely interventions for patients at high risk of ED. The majority of studies included in this review investigated only hyperactive ED and further research is required to determine risk factors for hypoactive and mixed ED types.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"190-200"},"PeriodicalIF":3.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71424305","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}

引用次数: 0

Visualizing the Future of Medical Communication: Infographics and Their Impact on Academic Medicine. 可视化医学交流的未来：信息图表及其对学术医学的影响。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2024-07-01 Epub Date: 2024-06-10 DOI: 10.1097/ANA.0000000000000970

Lauren K Licatino, Lindsay R Hunter Guevara, Arnoley S Abcejo

引用次数: 0

Autoregulatory Cerebral Perfusion Pressure Insults in Traumatic Brain Injury and Aneurysmal Subarachnoid Hemorrhage: The Role of Insult Intensity and Duration on Clinical Outcome. 创伤性脑损伤和动脉瘤性蛛网膜下腔出血的自调节脑灌注压损伤：损伤强度和持续时间对临床结果的影响。

IF 3.7 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2024-07-01 Epub Date: 2023-05-17 DOI: 10.1097/ANA.0000000000000922

Teodor Svedung Wettervik, Anders Hånell, Timothy Howells, Elisabeth R Engström, Anders Lewén, Per Enblad

{"title":"Autoregulatory Cerebral Perfusion Pressure Insults in Traumatic Brain Injury and Aneurysmal Subarachnoid Hemorrhage: The Role of Insult Intensity and Duration on Clinical Outcome.","authors":"Teodor Svedung Wettervik, Anders Hånell, Timothy Howells, Elisabeth R Engström, Anders Lewén, Per Enblad","doi":"10.1097/ANA.0000000000000922","DOIUrl":"10.1097/ANA.0000000000000922","url":null,"abstract":"Background: This single-center, retrospective study investigated the outcome effect of the combined intensity and duration of differences between actual cerebral perfusion pressure (CPP) and optimal cerebral perfusion pressure (CPPopt), and also for absolute CPP, in patients with traumatic brain injury (TBI) and aneurysmal subarachnoid hemorrhage (aSAH).Methods: A total of 378 TBI and 432 aSAH patients treated in a neurointensive care unit between 2008 and 2018 with at least 24 hours of CPPopt data during the first 10 days following injury, and with 6-month (TBI) or 12-month (aSAH) extended Glasgow Outcome Scale (GOS-E) scores, were included in the study. ∆CPPopt-insults (∆CPPopt=actual CPP-CPPopt) and CPP-insults were visualized as 2-dimensional plots to highlight the combined effect of insult intensity (mm Hg) and duration (min) on patient outcome.Results: In TBI patients, a zone of ∆CPPopt ± 10 mm Hg was associated with more favorable outcome, with transitions towards unfavorable outcome above and below this zone. CPP in the range of 60 to 80 mm Hg was associated with higher GOS-E, whereas CPP outside this range was associated with lower GOS-E. In aSAH patients, there was no clear transition from higher to lower GOS-E for ∆CPPopt-insults; however, there was a transition from favorable to unfavorable outcome when CPP was <80 mm Hg.Conclusions: TBI patients with CPP close to CPPopt exhibited better clinical outcomes, and absolute CPP within the 60 to 80 mm Hg range was also associated with favorable outcome. In aSAH patients, there was no clear transition for ∆CPPopt-insults in relation to outcome, whereas generally high absolute CPP values were associated overall with favorable recovery.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"228-236"},"PeriodicalIF":3.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9491615","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

Blood Pressure Management Goals in Critically Ill Aneurysmal Subarachnoid Hemorrhage Patients in Australia and New Zealand. 澳大利亚和新西兰动脉瘤性蛛网膜下腔出血重症患者的血压管理目标。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2024-07-01 Epub Date: 2023-07-13 DOI: 10.1097/ANA.0000000000000926

Toby Betteridge, Mark Finnis, Jeremy Cohen, Anthony Delaney, Paul Young, Andrew Udy

{"title":"Blood Pressure Management Goals in Critically Ill Aneurysmal Subarachnoid Hemorrhage Patients in Australia and New Zealand.","authors":"Toby Betteridge, Mark Finnis, Jeremy Cohen, Anthony Delaney, Paul Young, Andrew Udy","doi":"10.1097/ANA.0000000000000926","DOIUrl":"10.1097/ANA.0000000000000926","url":null,"abstract":"Introduction: Blood pressure (BP) management is common in patients with aneurysmal subarachnoid hemorrhage (SAH) admitted to an intensive care unit. However, the practice patterns of BP management (timing, dose, and duration) have not been studied locally.Methods: This post hoc analysis explored BP management goals (defined as the setting of a minimum systolic BP target or application of induced hypertension) in patients enrolled into the PROMOTE-SAH study in eleven neurosurgical centers in Australia and New Zealand. The primary outcome was 'dead or disabled' (modified Rankin Score ≥4) at 6 months, with the hypothesis being that setting BP management goals would be associated with improved outcomes.Results: BP management goals were recorded in 266 of 357 (75%) patients, of which 149 were recorded as receiving induced hypertension for delayed cerebral ischemia (DCI) or vasospasm on 738 (19%) study days. In patients with a minimum systolic BP goal recorded (on 2067 d), the indication for the BP management goal was vasospasm or DCI on 651 (32%) days; no indication for BP management goals was documented on 1416 (69%) days. Crude analysis demonstrated an association between setting BP management goals and reduced death or disability ( P =0.03), but this association was not significant after adjustment for the presence of DCI or vasospasm and clustered by the site.Conclusions: BP management goals are commonly 'prescribed' to aSAH patients admitted to an intensive care unit in Australia and New Zealand, but BP management goal setting was not associated with improved outcomes in the adjusted analysis.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"237-243"},"PeriodicalIF":2.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10134907","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}

引用次数: 0

Designing Enhanced Recovery After Surgery Protocols in Neurosurgery: A Contemporary Narrative Review. 设计神经外科手术后增强恢复方案:当代叙事回顾。

IF 3.7 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2024-07-01 Epub Date: 2023-11-22 DOI: 10.1097/ANA.0000000000000946

Sagar Jolly, Shashank Paliwal, Aditya Gadepalli, Sheena Chaudhary, Hemant Bhagat, Rafi Avitsian

引用次数: 0