Journal of neurosurgical anesthesiology最新文献_第6页

Intensive Versus Standard Blood Pressure Management after Endovascular Therapy for Acute Ischemic Stroke: A Systematic Review and Meta-analysis. 急性缺血性脑卒中血管内治疗后的强化血压管理与标准血压管理：系统综述与元分析》。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-01-01 Epub Date: 2024-04-01 DOI: 10.1097/ANA.0000000000000961

Kangda Zhang, Xinyan Wang, Youxuan Wu, Fa Liang, Xuan Hou, Zihui Zhang, Anxin Wang, Liping Liu, Ruquan Han

{"title":"Intensive Versus Standard Blood Pressure Management after Endovascular Therapy for Acute Ischemic Stroke: A Systematic Review and Meta-analysis.","authors":"Kangda Zhang, Xinyan Wang, Youxuan Wu, Fa Liang, Xuan Hou, Zihui Zhang, Anxin Wang, Liping Liu, Ruquan Han","doi":"10.1097/ANA.0000000000000961","DOIUrl":"10.1097/ANA.0000000000000961","url":null,"abstract":"Prospective clinical studies on blood pressure (BP) management targets after endovascular therapy (EVT) for acute ischemic stroke (AIS) have recently been published. Our objective was to assess the impact on clinical outcomes of BP management guided by established systolic BP (SBP) targets within the first 24 hours after successful EVT. Four randomized controlled trials (RCTs) including 1556 participants across 5 SBP target settings identified from 5 databases up to September 6, 2023 were included in this systematic review and meta-analysis. All the intensive SBP target groups in these RCTs were combined to facilitate head-to-head comparisons. Patients receiving intensive SBP management had lower risk of 90-day functional independence as assessed by the modified Rankin scale score (relative risk [RR], 0.81; 95% confidence interval [CI], 0.72 to 0.91; I2 , 12%), excellent outcomes (RR,0.86; 95% CI, 0.75 to 0.99; I2 , 7%), favorable outcomes (RR, 0.85; 95% CI, 0.78 to 0.92; I2 , 0%), and quality of life (standardized mean difference, -0.22; 95% CI, -0.35 to -0.10; I 2 ,0%). There were no differences in the probability of any intracerebral hemorrhage (RR, 1.04; 95% CI, 0.92 to 1.19; I2 ,0%), symptomatic intracerebral hemorrhage (RR, 1.10; 95% CI, 0.76 to 1.60; I2 , 0%), stroke-related death (RR, 1.16; 95% CI, 0.80 to 1.68; I2 , 0%), or parenchymal hematoma (RR, 1.71; 95% CI, 0.74 to 3.98; I2 , 47%) between SBP targets. This meta-analysis provides evidence from RCTs suggesting that intensive SBP control (target<160 mm Hg) may be detrimental to clinical outcomes in AIS patients with successful reperfusion after EVT.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"20-30"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335973","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

What Can the Electroencephalogram Tell Us About Sedation? 关于镇静，脑电图能告诉我们什么？

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-01-01 Epub Date: 2024-12-02 DOI: 10.1097/ANA.0000000000000991

Lisa R Lynch, Neeta Saraiya, Jerry Chao, Ian Yuan

引用次数: 0

Time to Wake Up to Remimazolam's Potential. 是时候唤醒雷美马唑仑的潜力了。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-01-01 Epub Date: 2024-10-09 DOI: 10.1097/ANA.0000000000001009

Matthew B Allen, Nicolai Goettel

引用次数: 0

Anesthesia on Clinical Outcomes in an Extended Time Window During Endovascular Stroke Therapy: Exploratory Analysis of the ANGEL-ACT Registry. 血管内卒中治疗过程中麻醉对临床结果的影响：ANGEL-ACT 登记的探索性分析。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-01-01 Epub Date: 2024-03-28 DOI: 10.1097/ANA.0000000000000959

Xinyan Wang, Fa Liang, Youxuan Wu, Baixue Jia, Xiaoli Zhang, Minyu Jian, Haiyang Liu, Anxin Wang, Zhongrong Miao, Ruquan Han

{"title":"Anesthesia on Clinical Outcomes in an Extended Time Window During Endovascular Stroke Therapy: Exploratory Analysis of the ANGEL-ACT Registry.","authors":"Xinyan Wang, Fa Liang, Youxuan Wu, Baixue Jia, Xiaoli Zhang, Minyu Jian, Haiyang Liu, Anxin Wang, Zhongrong Miao, Ruquan Han","doi":"10.1097/ANA.0000000000000959","DOIUrl":"10.1097/ANA.0000000000000959","url":null,"abstract":"Objective: Data on the impact of different anesthesia methods on clinical outcomes in patients with acute ischemic stroke undergoing endovascular therapy (EVT) in extended windows are limited. This study compared clinical outcomes in patients with stroke having general anesthesia (GA), conscious sedation (CS), or local anesthesia (LA) during EVT in extended (>6 h) time windows.Methods: We conducted an exploratory analysis of data from the ANGEL-ACT registry. The primary outcome was the modified Rankin Scale (mRS) score at 90 days. Secondary outcomes included the proportions of patients with mRS scores of 0 to 1, 0 to 2, and 0 to 3, and safety outcomes were any intracranial hemorrhage (ICH), symptomatic ICH, or mortality within 90 days. Multivariate analyses, inverse probability of treatment weighting, and coarsened exact matching were used to adjust for indication bias.Results: A total of 646 patients were included in the analysis (GA,280; CS, 103; LA, 263). Patients having LA during EVT were more likely to have a favorable mRS score (adjusted odds ratio [aOR]: 1.75; 95% CI: 1.28 to 2.40) and a lower incidence of symptomatic ICH (aOR: 0.33; 95% CI: 0.14 to 0.76) than those having GA group. Similarly, CS was associated with greater odds of favorable 90-day mRS scores compared with GA (aOR: 1.69; 95% CI: 1.11 to 2.56). Posterior circulation stroke was overrepresented in the GA group (29.6%) and may be a reason for the worse outcomes in the GA group.Conclusions: Patients who received LA or CS had better neurological outcomes than those who received GA within extended time windows in a real-world setting.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"64-69"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305957","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

Antiplatelet Agents in Endovascular Neurointerventional Procedures. 血管内神经介入手术中的抗血小板药物。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-01-01 Epub Date: 2024-10-28 DOI: 10.1097/ANA.0000000000001010

Kelley Flesher, Sophia Pathan, William Andrew Kofke

{"title":"Antiplatelet Agents in Endovascular Neurointerventional Procedures.","authors":"Kelley Flesher, Sophia Pathan, William Andrew Kofke","doi":"10.1097/ANA.0000000000001010","DOIUrl":"10.1097/ANA.0000000000001010","url":null,"abstract":"Minimally invasive, image-guided endovascular procedures are becoming increasingly prevalent as techniques and technologies have advanced, particularly within the realm of neurovascular interventions. Endovascular approaches ubiquitously result in endothelial injury with subsequent risk of thromboembolic complications. Periprocedural antiplatelet agent use is an integral component of the management of patients undergoing endovascular neurointerventional procedures. This patient population has a unique risk profile encompassing thromboembolic and hemorrhagic complications simultaneously, and the precise balance of these risks impacts patient outcomes almost as much as the interventional procedure itself. Clinical experience and study consensus demonstrate overall improved outcomes with the use of periprocedural antiplatelet agents, though current practices remain highly institution and practitioner-dependent. This focused review will discuss the major mechanisms of action of antiplatelet agents, and their clinical indications and management in the periprocedural neurointerventional setting. Despite the importance of antiplatelet agents in the management of neurointerventional patients, many questions remain. Further research and clinical expertise are needed to establish standardized, procedure-specific, antiplatelet regimens as well as standardized monitoring of antiplatelet agent regimen efficacy and safety.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":"37 1","pages":"4-10"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066246","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

Use of the Electroencephalogram to Measure Pain in Infants and Young Children. 使用脑电图测量婴儿和幼儿的疼痛。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-01-01 Epub Date: 2024-12-02 DOI: 10.1097/ANA.0000000000001001

Jennifer Busse, Stephanie Chen, Kelin Brace, Rebeccah Slater

引用次数: 0

Sedation Strategies in Pediatric Intensive Care Unit Patients: Challenges in Management. 儿科重症监护病房患者的镇静策略：管理上的挑战。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-01-01 Epub Date: 2024-12-02 DOI: 10.1097/ANA.0000000000000994

Shawn S Jackson, Teeda Pinyavat, Hulya Bayir, Heidi A B Smith

引用次数: 0

Updates on the NIH Toolbox V3 and Introduction to the NIHTB Infant and Toddler Toolbox and Mobile Toolbox. 更新NIH工具箱V3和介绍NIHTB婴幼儿工具箱和移动工具箱。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-01-01 Epub Date: 2024-12-02 DOI: 10.1097/ANA.0000000000001000

Matthew Monteleone, Katherine Biagas, Neeta Saraiya, Stephanie Young

引用次数: 0

The Use of Real-world Data to Generate Real-world Evidence to Accelerate Neonatal Drug Development. 使用真实数据生成真实证据以加速新生儿药物开发。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-01-01 Epub Date: 2024-12-02 DOI: 10.1097/ANA.0000000000000989

Shawn S Jackson, Joseph P Cravero, Lena Sun, Jonathan M Davis

引用次数: 0

High Intraoperative Serum Lactate Level is Associated with Acute Kidney Injury after Brain Tumor Resection. 术中血清乳酸水平过高与脑肿瘤切除术后急性肾损伤有关

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-01-01 Epub Date: 2024-01-29 DOI: 10.1097/ANA.0000000000000954

Seungeun Choi, Jiwon You, Yoon Jung Kim, Hyung-Chul Lee, Hee-Pyoung Park, Chul-Kee Park, Hyongmin Oh

{"title":"High Intraoperative Serum Lactate Level is Associated with Acute Kidney Injury after Brain Tumor Resection.","authors":"Seungeun Choi, Jiwon You, Yoon Jung Kim, Hyung-Chul Lee, Hee-Pyoung Park, Chul-Kee Park, Hyongmin Oh","doi":"10.1097/ANA.0000000000000954","DOIUrl":"10.1097/ANA.0000000000000954","url":null,"abstract":"Background: Postoperative acute kidney injury (AKI) is associated with poor clinical outcomes. Identification of risk factors for postoperative AKI is clinically important. Serum lactate can increase in situations of inadequate oxygen delivery and is widely used to assess a patient's clinical course. We investigated the association between intraoperative serum lactate levels and AKI after brain tumor resection.Methods: Demographics, medical and surgical history, tumor characteristics, surgery, anesthesia, preoperative and intraoperative blood test results, and postoperative clinical outcomes were retrospectively collected from 4131 patients who had undergone brain tumor resection. Patients were divided into high (n=1078) and low (n=3053) lactate groups based on an intraoperative maximum serum lactate level of 3.35 mmol/L. After propensity score matching, 1005 patients were included per group. AKI was diagnosed using the Kidney Disease Improving Global Outcomes criteria, based on serum creatinine levels within 7 days after surgery.Results: Postoperative AKI was observed in 53 (1.3%) patients and was more frequent in those with high lactate both before (3.2% [n=35] vs. 0.6% [n=18]; P < 0.001) and after (3.3% [n=33] vs. 0.6% [n=6]; P < 0.001) propensity score matching. Intraoperative predictors of postoperative AKI were maximum serum lactate levels > 3.35 mmol/L (odds ratio [95% confidence interval], 3.57 [1.45-8.74], P = 0.005), minimum blood pH (odds ratio per 1 unit, 0.01 [0.00-0.24], P = 0.004), minimum hematocrit (odds ratio per 1%, 0.91 [0.84-1.00], P = 0.037), and mean serum glucose levels > 200 mg/dL (odds ratio, 6.22 [1.75-22.16], P = 0.005).Conclusion: High intraoperative serum lactate levels were associated with AKI after brain tumor resection.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"55-63"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139642369","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