Journal of neurosurgical anesthesiology最新文献

{"title":"Perioperative Communication Challenges in Aphasic Patients.","authors":"Melissa Liu, Grace B Russo, Grace Mandigo, Shailendra Joshi","doi":"10.1097/ANA.0000000000001138","DOIUrl":"10.1097/ANA.0000000000001138","url":null,"abstract":"","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"367-369"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148251834","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":"Ventriculostomy-Related Infections by Country-Income Level: A Systematic Review and Bayesian Hierarchical Meta-analysis.","authors":"Samuel N Blacker, Hemanshu Prabhakar, Elizabeth Olive Moreton, Mark Burbridge, Lauren Dunn, Lindsey N Gouker, Benjamin J Heller, Kiran Jangra, Mia Kang, Jacob W Nadler, Veerle De Sloovere, Alex Raquer, Gentle S Shrestha, Brian Sindelar, James Williams, Daniel Winecoff, Vishal Yajnik, Abhijit V Lele","doi":"10.1097/ANA.0000000000001123","DOIUrl":"10.1097/ANA.0000000000001123","url":null,"abstract":"<p><p>Our objective was to perform a systematic review and meta-analysis of published literature on ventriculostomy-related infection (VRI) and evaluate temporal and global trends. We conducted a systematic review and Bayesian hierarchical random-effects meta-analysis of VRI rates in adults, stratified by country-income level (high-income countries [HIC]; low- or middle-income countries [LMIC]), study design, sample size, enrollment period, VRI intervention, and VRI definition. We identified 159 articles published between 1989 and 2025 that included 523,704 patients with 7293 VRIs. The pooled VRI rate was 8.64% [95% CI: 7.44-9.97], with moderate heterogeneity and good model fit. The leave-one-out sensitivity analysis showed a mean absolute change of 0.06% and a maximum change of 0.2%, indicating robust analysis. Five of the 33 represented countries had VRI rates below the global pooled rate of 8.64%. Four were HICs: Singapore (VRI rate 3.3% [0.8-7]), the United States (VRI rate 4.6% [3.4-5.9]), Germany (VRI rate 6.1% [1.1-18.9]), Norway (8.3% [0.3-68.4]), with 1 LMIC: China (8.5% [5.4-12.4]). VRI was significantly higher in studies using definitions beyond CSF culture alone for VRI (+3.16% [0.11- 6.52]) and in those from Europe (+7.29% [4.62-10.10]) and the Western Pacific (+4.09% [1.55-6.98]). No other subgroup demonstrated significant differences. This Bayesian meta-analysis provides global estimates and factors associated with VRI. Standardization of VRI definitions is critical for future benchmarking of VRI rates.</p>","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"297-305"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148251832","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":"Early Oxygenation Levels and Clinical Outcomes in Postendovascular Therapy Ischemic Stroke: An Exploratory Analysis of the RESCUE-RE Registry.","authors":"Kangda Zhang, Xinyan Wang, Youxuan Wu, Fa Liang, Ruquan Han, Liping Liu","doi":"10.1097/ANA.0000000000001102","DOIUrl":"10.1097/ANA.0000000000001102","url":null,"abstract":"<p><strong>Background: </strong>Studies on oxygenation in acute ischemic stroke (AIS) mainly focus on the prehospital care and during endovascular therapy (EVT). This study aimed to explore the association between arterial oxygenation levels within the first 24 hours of intensive care unit (ICU) admission and neurological recovery, as well as pulmonary complications in AIS patients after EVT.</p><p><strong>Methods: </strong>We conducted an exploratory analysis of the multicenter RESCUE-RE registry, including 532 AIS patients who underwent EVT at 18 comprehensive stroke centers in China from January 2019 to June 2024. Patients were categorized by arterial blood gas measurements within 24 hours post-ICU admission into hypoxemia (PaO 2 <80 mm Hg), normoxemia (PaO 2 80 to 120 mm Hg), and hyperoxemia (PaO 2 >120 mm Hg) groups. The primary outcome was functional independence (modified Rankin Scale [mRS] score 0 to 2) at 90 days. Secondary outcomes included other mRS thresholds, 90-day all-cause mortality, neurological improvement/deterioration, and pulmonary infection incidence. Multivariable regression adjusted for confounders assessed associations between PaO 2 levels and outcomes.</p><p><strong>Results: </strong>Functional independence rates at 90 days did not differ significantly among hypoxemia (26.8%), normoxemia (27.2%), and hyperoxemia (24.5%) groups ( P =0.788). Adjusted analyses showed no significant association between PaO 2 levels and neurological outcomes or mortality. Secondary outcomes, including neurological changes, were also comparable across groups. Notably, normoxemia and hyperoxemia were associated with significantly lower pulmonary infection risk compared with hypoxemia (adjusted ORs: 0.48 to 0.63).</p><p><strong>Conclusions: </strong>In AIS patients undergoing EVT, early postoperative arterial oxygenation was not associated with 90-day neurological recovery, whereas hypoxemia was associated with pulmonary infection.</p>","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"358-364"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271238","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":"Transcranial Motor Evoked Potential Monitoring Using Propofol-Fentanyl Versus Desflurane-Dexmedetomidine Anesthesia During Spinal Cord Tumor Resection: A Randomized Controlled Trial.","authors":"Jennifer Shalini Ravikumar, Srinivas Babu, Bijesh R Nair, Bijesh Yadav, A Benjamin Franklin, Georgene Singh","doi":"10.1097/ANA.0000000000001087","DOIUrl":"10.1097/ANA.0000000000001087","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing resection of spinal cord tumours require intraoperative neuromonitoring. Transcranial electrical stimulation is used to record myogenic responses during surgery. This study aimed to compare the effect of 2 anaesthetic regimens, propofol/fentanyl versus desflurane/dexmedetomidine, on the ability to record MEPs with an amplitude of 50 µV or greater. Our secondary outcome compared intraoperative haemodynamics, recovery profile, and postoperative analgesia between the groups.</p><p><strong>Methods: </strong>We conducted a prospective, double-blinded, open-label, single-centre, randomized controlled trial of 50 adult patients undergoing spinal cord tumour resection with TcmMEP monitoring. Patients were randomized to 2 groups: Group P (n=25) received intravenous anaesthesia with propofol and fentanyl; group D (n=25) received desflurane and dexmedetomidine.</p><p><strong>Results: </strong>We recorded TcmMEP's in 80% of group P and 76% group D (95% CI: -23% to 31%, P =1.00). The time in minutes for spontaneous breathing (21.04±11.31 vs. 8.00±3.42 [8.29-,17.79, P =0.01]), extubation (31.56±17.56 vs. 10.84±3.99 [13.48-27.96; P =0.01]), emergence (33.68±18.11 vs. 10.92±4.01 [15.30-30.22, P =0.001]), discharge readiness (45.00±25.24 vs. 15.56±6.08 [19.00-39.88; P =0.001]) and requirement of first analgesia (136.6±108.04 vs. 230.8±81.33) (-148.58 to -39.82; P =0.01) was lower in group D compared with group P. Postoperative analgesia assessed using the Visual Analogue Score was lower in group D compared with group P at 12 and 24 hours. (1.68±1.18 vs. 0.64±1.31 [0.33-1.74 P =0.001]) :1.4±0.95 vs. 0.36± 0.70 (0.56-1.51; P =0.001).</p><p><strong>Conclusions: </strong>We found similar rates of successful TcMEP monitoring using desflurane-dexmedetomidine and propofol-fentanyl. Patients who received desflurane-dexmedetomidine had reduced emergence time, discharge readiness, and lower pain scores in the postoperative period.</p>","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"325-332"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146052511","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":"Rethinking the Heuristic Approach to Perioperative GLP-1 Receptor Agonist Management in Neurosurgical Patients.","authors":"Keta Thakkar, Jisu Kim","doi":"10.1097/ANA.0000000000001098","DOIUrl":"10.1097/ANA.0000000000001098","url":null,"abstract":"","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"373"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149951","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":"Success of First Intubation Attempt in Patients With History of Cervical Spine Fusion: A Retrospective Comparison Study.","authors":"Julia Parzych, Zaineb Dar, Fenghua Li, John L Ard, Laurel A Copeland, Eman Nada","doi":"10.1097/ANA.0000000000001109","DOIUrl":"10.1097/ANA.0000000000001109","url":null,"abstract":"<p><strong>Background: </strong>Cervical spine fusion causes limited neck mobility, a known risk factor for increased difficulty of endotracheal intubation. Cervical spine fusion surgeries are increasingly performed. The objective of this study was to determine the relationship between previous cervical spine fusion and subsequent endotracheal intubation.</p><p><strong>Materials and methods: </strong>This retrospective study included adult patients undergoing elective surgery requiring endotracheal intubation between 2015 and 2023. We used multivariable logistic regression to identify variables independently associated with the primary outcome: requiring more than one intubation attempt. Sensitivity analyses examined the outcome within only fusion patients.</p><p><strong>Results: </strong>We identified 938 patients, 436 with a history of cervical fusion, with 493 intubation attempts, and 502 nonfusion patients with 543 intubation attempts. The majority of the sample (91.5%) had fusion involving C3 or below, with 6.2% having a C1/C2 fusion(2.3% were missing the level of fusion). The success of the first attempt was 89.2% versus 92.6%, 8.5% versus 6.6% second attempt, and 2.3% versus 0.8% third attempt for fusion versus nonfusion patients, respectively. Requiring more than one attempt was associated with short thyromental distance, using multiple laryngoscopes, mouth trauma, and trainee status, but not with spinal fusion status (OR=1.29; 95% confident interval=079-2.12; P =0.312).</p><p><strong>Conclusion: </strong>Patients with a history of cervical spine fusion undergoing elective intubation experience similar rates of first intubation attempt failure compared with those without fusion when controlling for provider experience. Requiring more than one intubation attempt was associated with short thyromental distance, using multiple laryngoscopes, a trainee provider, and mouth trauma, but not a history of cervical fusion.</p>","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"333-339"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513000","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":"Airway Complications After Cervical Spine Surgery: A Focused Review on Recent Evidence and Perioperative Management.","authors":"Ammar Siddiqui, Jason Chui","doi":"10.1097/ANA.0000000000001152","DOIUrl":"10.1097/ANA.0000000000001152","url":null,"abstract":"<p><p>Airway complications after cervical spine surgery are infrequent but potentially catastrophic. The mechanisms of postoperative airway compromise differ according to surgical approach, extent of surgery, and underlying cervical pathology and include prevertebral and airway soft-tissue edema, retropharyngeal hematoma, recurrent laryngeal nerve dysfunction, cervical malalignment, and restricted cervical mobility. In patients with concomitant cervical spinal cord injury or myelopathy, impaired respiratory mechanics and bulbar dysfunction may further increase airway vulnerability. Recent evidence suggests that postoperative airway vulnerability is dynamic rather than confined to the immediate perioperative period, with clinically significant respiratory and swallowing complications occurring days to weeks after surgery, including some after hospital discharge. This focused review summarizes contemporary evidence regarding perioperative risk stratification, pathophysiology, extubation planning, postoperative surveillance, and preventive strategies for airway complications after cervical spine surgery. Potentially modifiable perioperative interventions, including goal-directed fluid therapy, corticosteroid administration, endotracheal tube cuff-pressure management, and selective delayed extubation in selected high-risk patients, are discussed. Although current evidence supports protocolized multidisciplinary airway management pathways, important gaps remain regarding individualized prediction of postoperative airway compromise, optimal extubation criteria, and postoperative monitoring strategy.</p>","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"306-314"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470965","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":"Outcome Hierarchy Matters When Interpreting Emergency Conversion to General Anesthesia During EVT.","authors":"Hailong Du","doi":"10.1097/ANA.0000000000001130","DOIUrl":"10.1097/ANA.0000000000001130","url":null,"abstract":"","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"372"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148226004","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 Dementia and Postoperative Dysphagia After Anterior Cervical Discectomy and Fusion.","authors":"Yu Chang, Yu-Shiuan Lin, Kuan-Yu Chi, Junmin Song, Hong-Min Lin","doi":"10.1097/ANA.0000000000001085","DOIUrl":"10.1097/ANA.0000000000001085","url":null,"abstract":"","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"365-366"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113412","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":"EEG Monitoring in the Operating Room: Navigating Technical and Patient-related Challenges.","authors":"Keta Thakkar","doi":"10.1097/ANA.0000000000001064","DOIUrl":"10.1097/ANA.0000000000001064","url":null,"abstract":"","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"370"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206813","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}