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Alternate Electrode Placements to Facilitate Frontal Electroencephalography Monitoring in Anesthetized and Critically Ill Patients. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2024-03-11 Oliver G Isik, Vikas Chauhan, Meah T Ahmed, Brian A Chang, Tuan Z Cassim, Morgan C Graves, Shobana Rajan, Paul S Garcia
Frontal electroencephalography (EEG) monitoring can be useful in guiding the titration of anesthetics, but it is not always feasible to place electrodes in the standard configuration in some circumstances, including during neurosurgery. This study compares 5 alternate configurations of the Masimo Sedline Sensor.
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Assessment and Recommendations for Website Platforms of Neuroanesthesiology Fellowship Programs. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2024-02-14 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
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
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High Intraoperative Serum Lactate Level is Associated with Acute Kidney Injury after Brain Tumor Resection. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2024-01-29 Seungeun Choi, Jiwon You, Yoon Jung Kim, Hyung-Chul Lee, Hee-Pyoung Park, Chul-Kee Park, Hyongmin Oh
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
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Real-time 3D Transesophageal Echocardiography for the Placement of Ventriculoatrial Shunt: A Case Series and Technical Note. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2024-01-17 Jason Chui, Keith MacDougall, Wai Ng
Ventriculoatrial (VA) shunts are used to manage hydrocephalus and idiopathic intracranial hypertension when peritoneal drainage of cerebrospinal fluid is not feasible. The technique of distal catheter placement during VA shunt insertion is controversial, especially between fluoroscopy-guided and transesophageal echocardiography (TEE)-guided techniques.
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Frailty: Implications for Neuroanesthesia. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2024-01-17 Amy Mitchell, Alana M Flexman
Frailty is increasingly prevalent in the aging neurosurgical population and is an important component of perioperative risk stratification and optimization to reduce complications. Frailty is measured using the phenotypic or deficit accumulation models, with simplified tools most commonly used in studies of neurosurgical patients. There are a limited number of frailty measurement tools that have been
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Utilizing Artificial Intelligence and Chat Generative Pretrained Transformer to Answer Questions About Clinical Scenarios in Neuroanesthesiology. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-12-19 Samuel N Blacker, Mia Kang, Indranil Chakraborty, Tumul Chowdhury, James Williams, Carol Lewis, Michael Zimmer, Brad Wilson, Abhijit V Lele
We tested the ability of chat generative pretrained transformer (ChatGPT), an artificial intelligence chatbot, to answer questions relevant to scenarios covered in 3 clinical guidelines, published by the Society for Neuroscience in Anesthesiology and Critical Care (SNACC), which has published management guidelines: endovascular treatment of stroke, perioperative stroke (Stroke), and care of patients
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Blood-brain Barrier Permeability May Influence Vasopressor Effects in Anesthetized Patients With Brain Tumor: An Analysis of Magnetic Resonance Imaging Data. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-12-08 Mads Rasmussen, Klaus U Koch, Ulrick S Espelund, Niwar Mohamad, Anders R Korshøj, Niels Juul, Hugo Angleys, Lingzhong Meng, Leif Østergaard, Irene K Mikkelsen
This is a secondary analysis of data from a previous study of anesthetized brain tumor patients receiving ephedrine or phenylephrine infusions. 18 patients with magnetic imaging verified tumor contrast enhancement were included. We hypothesized that vasopressors induce microcirculatory flow changes, characterized by increased capillary transit time heterogeneity (CTH) and decreased mean transit time
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Systemic Hypertension and Postoperative Symptomatic Spinal Epidural Hematoma: A Scoping Review. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-11-29 Lewis Robinson, Patrice Forget, David Nesvadba
Postoperative symptomatic spinal epidural hematoma (PSSEH) is a serious complication of spinal surgery that is associated with significant morbidity. Studies suggest that hypertension is a risk factor for the development of PSSEH. The aim of this review was to evaluate the literature reporting associations between hypertension and PSSEH. A comprehensive literature search was conducted using the MEDLINE/PubMed
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Impact of Intraoperative Fluctuations of Cardiac Output on Cerebrovascular Autoregulation: An Integrative Secondary Analysis of Individual-level Data. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-11-27 Ursula Kahl, Linda Krause, Sabrina Amin, Ulrich Harler, Stefanie Beck, Thorsten Dohrmann, Caspar Mewes, Markus Graefen, Alexander Haese, Christian Zöllner, Marlene Fischer
Intraoperative impairment of cerebral autoregulation (CA) has been associated with perioperative neurocognitive disorders. We investigated whether intraoperative fluctuations in cardiac index are associated with changes in CA.
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Designing Enhanced Recovery After Surgery Protocols in Neurosurgery: A Contemporary Narrative Review. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-11-22 Sagar Jolly, Shashank Paliwal, Aditya Gadepalli, Sheena Chaudhary, Hemant Bhagat, Rafi Avitsian
Enhanced Recovery After Surgery (ERAS) protocols have revolutionized the approach to perioperative care in various surgical specialties. They reduce complications, improve patient outcomes, and shorten hospital lengths of stay. Implementation of ERAS protocols for neurosurgical procedures has been relatively underexplored and underutilized due to the unique challenges and complexities of neurosurgery
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Effect of Repeated Exposure to Sevoflurane on Electroencephalographic Alpha Oscillation in Pediatric Patients Undergoing Radiation Therapy: A Prospective Observational Study. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-11-13 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
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.
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Association of Admission Glucose and Outcomes After Endovascular Treatment for Acute Stroke: Data From the ANGEL-ACT Registry. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-08-25 Xinyan Wang, Fa Liang, Youxuan Wu, Baixue Jia, Yijun Zhang, Minyu Jian, Haiyang Liu, Anxin Wang, Ruquan Han, Zhongrong Miao
The association between admission glucose levels and clinical outcomes after stroke has not been effectively elucidated. This study assessed the association among admission glucose levels, admission hyperglycemia, diabetes mellitus, and 90-day neurological outcomes in patients with acute ischemic stroke undergoing endovascular therapy.
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Evaluation of the Role of Preoperative Oral Amisulpride as Part of a Multimodal Antiemetic Prophylaxis Regime on Postoperative Nausea and Vomiting in Patients Undergoing Craniotomy: A Prospective, Double-Blind, Randomized, Placebo-controlled Study. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-08-22 Anubha Gupta, Devendra Gupta, Pragya Gupta, Rudrashish Haldar, Ruchi Verma, Prabhaker Mishra, Shashi Srivastava
Patients undergoing craniotomy are at high risk for postoperative nausea and vomiting (PONV) despite the use of prophylactic antiemetics. We hypothesized that a single preoperative oral dose of amisulpride as part of a multimodal antiemetic regimen would decrease the incidence of PONV in patients undergoing craniotomy for intracranial tumor surgery.
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Obesity Paradox for Postoperative Mortality in Young Chinese Patients Undergoing Craniotomy for Brain Tumor Resection. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-08-03 Jialing He, Lu Jia, Yu Zhang, Yixin Tian, Pengfei Hao, Tiangui Li, Yangchun Xiao, Liyuan Peng, Yuning Feng, Xin Cheng, Haidong Deng, Peng Wang, Weelic Chong, Yang Hai, Lvlin Chen, Chao You, Fang Fang
There is little evidence regarding the association of body mass index (BMI) with postoperative mortality after craniotomy, especially in the Asian population. Our study aimed to explore the association between BMI and postoperative 30-day mortality in Chinese patients undergoing craniotomy for brain tumor resection.
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Cerebral Autoregulation-guided Management of Adult and Pediatric Traumatic Brain Injury. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-07-31 Abhijit V Lele, Monica S Vavilala
Cerebral autoregulation (CA) plays a vital role in maintaining cerebral blood flow in response to changes in systemic blood pressure. Impairment of CA following traumatic brain injury (TBI) may exacerbate the injury, potentially impacting patient outcomes. This focused review addresses 4 key questions regarding the measurement, natural history of CA after TBI, and potential clinical implications of
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The Effect of Oral Nimodipine on Cerebral Metabolism and Hemodynamic Parameters in Patients Suffering Aneurysmal Subarachnoid Hemorrhage. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-07-27 Miriam Moser, Yannik Schwarz, Johannes Herta, Walter Plöchl, Andrea Reinprecht, Markus Zeitlinger, Jonas Brugger, Dariga Ramazanova, Karl Rössler, Arthur Hosmann
Nimodipine is routinely administered to aneurysmal subarachnoid hemorrhage patients to improve functional outcomes. Nimodipine can induce marked systemic hypotension, which might impair cerebral perfusion and brain metabolism.
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Blood Pressure Management Goals in Critically Ill Aneurysmal Subarachnoid Hemorrhage Patients in Australia and New Zealand. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-07-13 Toby Betteridge, Mark Finnis, Jeremy Cohen, Anthony Delaney, Paul Young, Andrew Udy
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.
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Demonstrating the Value of Routine Anesthesiologist Involvement in Acute Stroke Care: A Retrospective Chart Review. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-07-11 Robert J McCusker, Vernon M Chinchilli, Chanju D Fritch, Puneet S Kochar, Sonal Sharma
The value of routine involvement of anesthesiologists during endovascular thrombectomy (EVT) for acute ischemic stroke has not been clearly demonstrated. At some institutions, anesthesiologists are involved only as needed, while at other institutions, anesthesiologists are involved from the beginning for every EVT.
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The Role of Remimazolam in Neurosurgery and in Patients With Neurological Diseases: A Narrative Review. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-05-31 Miguel T Teixeira, Nathan J Brinkman, Jeffrey J Pasternak, Arnoley S Abcejo
Remimazolam is a novel ultrashort-acting benzodiazepine that produces sedation by acting as a positive allosteric modulator of the gamma-amino butyric acid-A receptor. Its high water solubility and metabolism via tissue esterases allow for a rapid onset of sedation/anesthesia and prompt arousal despite prolonged use. In addition, the effects of remimazolam can be reversed with flumazenil. This narrative
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A Survey on Monitoring and Management of Cerebral Vasospasm and Delayed Cerebral Ischemia After Subarachnoid Hemorrhage: The Mantra Study. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-05-26 Edoardo Picetti, Pierre Bouzat, Mary Kay Bader, Giuseppe Citerio, Raimund Helbok, Janneke Horn, Robert Loch Macdonald, Victoria McCredie, Geert Meyfroidt, Cássia Righy, Chiara Robba, Deepak Sharma, Wade S Smith, Jose I Suarez, Andrew Udy, Stefan Wolf, Fabio S Taccone
Cerebral infarction from delayed cerebral ischemia (DCI) is a leading cause of poor neurological outcome after aneurysmal subarachnoid hemorrhage (aSAH). We performed an international clinical practice survey to identify monitoring and management strategies for cerebral vasospasm associated with DCI in aSAH patients requiring intensive care unit admission.
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Autoregulatory Cerebral Perfusion Pressure Insults in Traumatic Brain Injury and Aneurysmal Subarachnoid Hemorrhage: The Role of Insult Intensity and Duration on Clinical Outcome. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-05-17 Teodor Svedung Wettervik, Anders Hånell, Timothy Howells, Elisabeth R Engström, Anders Lewén, Per Enblad
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).
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A Global Review of the Perioperative Care of Patients With Aneurysmal Subarachnoid Hemorrhage Undergoing Microsurgical Repair of Ruptured Intracerebral Aneurysm. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-04-19 Abhijit V Lele, Ananya Abate Shiferaw, Marie Angele Theard, Monica S Vavilala, Cristiane Tavares, Ruquan Han, Denekew Assefa, Mihret Dagne Alemu, Charu Mahajan, Monica S Tandon, Neeta V Karmarkar, Vasudha Singhal, Ritesh Lamsal, Umeshkumar Athiraman
To describe the perioperative care of patients with aneurysmal subarachnoid hemorrhage (aSAH) who undergo microsurgical repair of a ruptured intracerebral aneurysm.
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Adding Ketamine to Epidural Morphine Does Not Prolong Postoperative Analgesia After Lumbar Laminectomy or Discectomy J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-03-29 Prasadkanna Prabhakar, Ramamani Mariappan, Ranjith K. Moorthy, Bijesh R. Nair, Reka Karuppusami, Karen R. Lionel
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
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Anesthesiology Performance Improvement and Reporting Exchange (ASPIRE) Quality Metrics in Patients Undergoing Decompressive Craniectomy and Endoscopic Clot Evacuation after Spontaneous Supratentorial Intracerebral Hemorrhage: A Retrospective Observational Study J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-03-21 Abhijit V. Lele, Christine T. Fong, Shu-Fang Newman, Vikas O’Reilly-Shah, Andrew M. Walters, Umeshkumar Athiraman, Michael J. Souter, Michael R. Levitt, Monica S. Vavilala
Background: We report adherence to 6 Anesthesiology Performance Improvement and Reporting Exchange (ASPIRE) quality metrics (QMs) relevant to patients undergoing decompressive craniectomy or endoscopic clot evacuation after spontaneous supratentorial intracerebral hemorrhage (sICH). Methods: In this retrospective observational study, we describe adherence to the following ASPIRE QMs: acute kidney
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Regional Anesthesia Techniques in Modern Neuroanesthesia Practice: A Narrative Review of the Clinical Evidence J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-03-20 Kan Ma, Jamie L. Uejima, John F. Bebawy
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
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Incremental Cost-effectiveness Analysis on Length of Stay of an Enhanced Recovery After Spine Surgery Program: A Single-center, Retrospective Cohort Study J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-04-01 Bhiken I. Naik, Lauren K. Dunn, Tanya N. Wanchek
Background: Enhanced recovery after spine surgery (ERAS) is increasingly utilized to improve postoperative outcomes and reduce cost. There are limited data on the monetary benefits of ERAS when incorporating the costs of developing, operationalizing, and maintaining ERAS programs. The objective of this study was to calculate the incremental cost-effectiveness of a spine surgery ERAS program, modeling
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Multimodal Analgesia and Intraoperative Neuromonitoring J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-04-01 Kan Ma, John F. Bebawy, Laura B. Hemmer
Intraoperative neuromonitoring has been a valuable tool for ensuring the functional integrity of vital neural structures by providing real-time feedback to the operative team during procedures where neurological structures are at risk. Commonly used intravenous and inhaled anesthetic drugs are known to affect waveform parameters measured with various intraoperative neuromonitoring modalities. While
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Inhalational Versus Propofol-based Intravenous Maintenance of Anesthesia for Emergence Delirium in Adults: A Meta-analysis and Trial Sequential Analysis J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-04-01 Yong Yang, Lin Feng, Chengcheng Ji, Kaizhi Lu, Yang Chen, Bing Chen
Emergence delirium (ED) is a severe postoperative complication that increases the risk for injury, self-extubation, and hemorrhage. Inhalational maintenance of anesthesia is a risk factor for ED in pediatric patients, but its impact in adults is undefined. This meta-analysis compares the incidence of ED between inhalational and propofol-based intravenous maintenance of anesthesia. Following a search
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Risk Factors and Characteristics of Intraoperative Seizures During Awake Craniotomy: A Retrospective Cohort Study of 562 Consecutive Patients With a Space-occupying Brain Lesion J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-04-01 Gabriel Paquin-Lanthier, Sudhakar Subramaniam, Kok Weng Leong, Abigail Daniels, Kawalpreet Singh, Hirokazu Takami, Tumul Chowdhury, Mark Bernstein, Lashmi Venkatraghavan
Introduction: Intraoperative seizures (IOSs) during awake craniotomy (AC) are associated with significant morbidity. The reported incidence of IOS is between 3% and 30%. The aim of this study was to identify risk factors for IOS during AC for elective resection or biopsy of a space-occupying brain lesion. Methods: In this retrospective study, we reviewed the records of all awake craniotomies performed
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Implementation of an Online External Ventricular Drain Training Module—An Educational Initiative to Improve Proficiency of Perioperative Health Care Providers: Results of a Retrospective Study J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-04-01 Abhijit V. Lele, Riikka S.K. Takala, Umeshkumar Athiraman, Nina Schloemerkemper, Suneeta Gollapudy, Kamila Vagnerova, Anita Vincent, Katherine E. Roberts, Sarah Wahlster, Monica S. Vavilala
Background: An external ventricular drain (EVD) training module may improve the knowledge and proficiency of perioperative health care providers (HCPs). Methods: We examined knowledge gaps, self-reported comfort in managing EVDs, and improvement in self-assessment scores among HCPs from 7 academic medical centers based on an online EVD training module. Results: Of the 326 HCPs who completed the
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Intracranial Pressure Variability: A New Potential Metric of Cerebral Ischemia and Energy Metabolic Dysfunction in Aneurysmal Subarachnoid Hemorrhage? J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-04-01 Teodor Svedung Wettervik, Timothy Howells, Anders Hånell, Elisabeth Ronne-Engström, Anders Lewén, Per Enblad
Background: It was recently reported that lower intracranial pressure variability (ICPV) is associated with delayed ischemic neurological deficits and unfavorable outcomes in patients with aneurysmal subarachnoid hemorrhage (aSAH). In this study, we aimed to determine whether lower ICPV also correlated with worse cerebral energy metabolism after aSAH. Methods: A total of 75 aSAH patients treated
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A Machine Learning Approach for Predicting Real-time Risk of Intraoperative Hypotension in Traumatic Brain Injury J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-04-01 Shara I. Feld, Daniel S. Hippe, Ljubomir Miljacic, Nayak L. Polissar, Shu-Fang Newman, Bala G. Nair, Monica S. Vavilala
Background: Traumatic brain injury (TBI) is a major cause of death and disability. Episodes of hypotension are associated with worse TBI outcomes. Our aim was to model the real-time risk of intraoperative hypotension in TBI patients, compare machine learning and traditional modeling techniques, and identify key contributory features from the patient monitor and medical record for the prediction of
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Effect of Sugammadex During Transcranial Electrical Motor Evoked Potentials Monitoring in Spinal Surgery: A Randomized Controlled Trial J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-04-01 Haiyang Liu, Minyu Jian, Chengwei Wang, Lanyi Nie, Fa Liang, Kuo Liu, Kaiying Zhang, Hui Qiao, Ruquan Han
Introduction: Neuromuscular blockade suppresses transcranial electrical motor evoked potential (TceMEP) amplitude and is usually avoided during TceMEP monitoring. In this randomized controlled trial, we investigated whether rocuronium-induced suppression of TceMEP amplitude could be reversed by sugammadex in patients undergoing spine surgery. Methods: Seventy-six patients undergoing spinal surgery
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Release of Hyaluronan in Aneurysmal Subarachnoid Hemorrhage and Cerebral Vasospasm: A Pilot Study Indicating a Shedding of the Endothelial Glycocalyx J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-04-01 Volker C. Schick, Tobias Neumann, Anja Illerhaus, Marco Timmer, Alexander Fuchs, Stefan Grau, Thorsten Annecke
Background: This pilot study investigated plasma concentrations of hyaluronan, heparan sulfate, and syndecan-1 as possible biomarkers for glycocalyx integrity after aneurysmal subarachnoid hemorrhage (aSAH). Methods: Daily blood samples for biomarker assay were obtained in aSAH patients on the intensive care unit stay and compared with samples from a historic cohort of 40 healthy controls. In post
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Correlation Between Cerebral Tissue Oxygen Saturation and Oxygen Extraction Fraction During Anesthesia: Monitoring Cerebral Metabolic Demand-supply Balance During Vasopressor Administration J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-04-01 Klaus U. Koch, Xu Zhao, Irene K. Mikkelsen, Ulrick S. Espelund, Joel Aanerud, Mads Rasmussen, Lingzhong Meng
Background: The speculation that cerebral tissue oxygen saturation (SctO2) measured using tissue near-infrared spectroscopy reflects the balance between cerebral metabolic rate of oxygen and cerebral oxygen delivery has not been validated. Our objective was to correlate SctO2 with cerebral oxygen extraction fraction (OEF) measured using positron emission tomography; OEF is the ratio between cerebral
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The Utility of COMPASS-31 Questionnaire to Predict Autonomic Dysfunction in Patients With Cervical/Upper Thoracic Compressive Myelopathy J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-04-01 Tanushree Takri, Rosen Roy Mathew, Ajith Sivadasan, Krishnaprabhu Raju, Reka Karuppusami, Ramamani Mariappan
Background: Patients with cervical/upper thoracic compressive myelopathy may have autonomic dysfunction. The composite autonomic severity score (CASS) is the gold standard test to detect autonomic dysfunction, and the self-rated composite autonomic system scale (COMPASS-31) questionnaire is a screening tool to diagnose autonomic dysfunction. This study compared the COMPASS-31 and modified CASS scores
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Evaluating the Anatomic Spread of Selective Nerve Scalp Blocks Using Methylene Blue: A Cadaveric Analysis J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-04-01 Monica W. Harbell, Patrick B. Bolton, Veerandra Koyyalamudi, David P. Seamans, Natalie R. Langley
Background: The modern scalp block consists of local anesthesia injections that target the supraorbital, supratrochlear, zygomaticotemporal, auriculotemporal, and greater and lesser occipital nerves. Limited data exist on the local anesthetic spread that occurs with this technique. This study examines the extent of the spread of a scalp block using methylene blue in a cadaveric model. Methods: A
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Neuroanesthesiology Quality Improvement Reporting Patterns: A Tertiary Medical Center Experience. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-03-08 Ian R Slade, Jen-Ting Yang, David R Wright, Adrienne James, Deepak Sharma
Understanding quality improvement (QI) reporting patterns is important for practice-based improvement and for prioritizing QI initiatives. The aim of this project was to identify major domains of neuroanesthesiology QI reports at a single academic institution with 2 hospital-based practice sites.
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T2-weighted Imaging Hyperintensity and Transcranial Motor-evoked Potentials During Cervical Spine Surgery: Effects of Sevoflurane in 150 Consecutive Cases. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-02-20 Nicole LeClair, Milca Ejimone, Davene Lynch, Jayanth Dasika, Dinesh Rao, Amie L Hoefnagel, Paul D Mongan
There is debate on the impact of inhalational esthetic agents on transcranial motor evoked potentials (TcMEPs) during intraoperative neuromonitoring. Current guidelines advise their avoidance, which contrasts with common clinical practice.
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Safety, Efficacy, and Clinical Outcomes of Dexmedetomidine for Sedation in Traumatic Brain Injury: A Scoping Review. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-02-15 Jordan Hatfield, Alexandria L Soto, Margot Kelly-Hedrick, Samantha Kaplan, Jordan M Komisarow, Tetsu Ohnuma, Vijay Krishnamoorthy
Dexmedetomidine is a promising alternative sedative agent for moderate-severe Traumatic brain injury (TBI) patients. Although the data are limited, the posited benefits of dexmedetomidine in this population are a reduction in secondary brain injury compared with current standard sedative regimens. In this scoping review, we critically appraised the literature to examine the effects of dexmedetomidine
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A High Immediate Postoperative Neutrophil-to-Albumin Ratio is Associated With Unfavorable Clinical Outcomes at Hospital Discharge in Patients With Aneurysmal Subarachnoid Hemorrhage. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-02-13 Kyung Won Shin, Seungeun Choi, Hyongmin Oh, So Yeong Hwang, Hee-Pyoung Park
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.
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Clinical Effects and Adverse Events Associated With Desflurane Use in Adult Patients Undergoing Supratentorial Craniotomy: A Systematic Review J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-01-30 Georgios Gkantinas, Eleni Ι. Tataki, Panagis M. Lykoudis, Eleftheria Lelekaki, Pinelopi Kouki
Desflurane is an inhalational anesthetic agent with an appealing recovery profile. The present systematic review investigates the clinical effects and adverse events associated with desflurane use during supratentorial craniotomy for brain tumor resection in adults in comparison with other inhalational and intravenous anesthetic agents. A literature search was conducted across the MEDLINE, Library
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Modified thoracolumbar Interfascial Plane Block Versus Erector Spinae Plane Block in Patients Undergoing Spine Surgeries: A Randomized Controlled Trial. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-01-09 Amarjeet Kumar, Chandni Sinha, Ajeet Kumar, Poonam Kumari, Abhyuday Kumar, Prabhat Agrawal, Chethan Vamshi
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.
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Ultrasound-guided Greater Occipital Nerve Block in Children Undergoing Posterior Fossa Craniotomy: A Randomized, Controlled Trial. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-01-09 Heba Nassar, Khaled Sarhan, Maha Gamil, Manal Elgohary, Hany El-Hadi, Sahar Mahmoud
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.
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Opioid-Free Anesthesia for Craniotomy J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-01-01 Ian L. McCullough, Jack W. Shteamer, Andrew M. Erwood, Boris Spektor, David W. Boorman, Milad Sharifpour, Jeffery J. Olson, Alexander Papangelou
Background: Perioperative opioids are problematic following craniotomy as they can impede neurological examination because of excessive sedation and mask surgical complications. Multimodal anesthetic techniques including nerve blocks have been used successfully to deliver opioid-free anesthesia in other surgical populations; however, no clinical data evaluating opioid-free anesthesia for craniotomy
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Characteristics of Gut Microbiome After Traumatic Brain Injury J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-01-01 Charu Mahajan, Surbhi Khurana, Indu Kapoor, Suman Sokhal, Subodh Kumar, Hemanshu Prabhakar, Purva Mathur, Kalaivani Mani
Background: Preclinical studies have reported significant changes in the gut microbiome after traumatic brain injury (TBI). We hypothesized that TBI induces the growth of Proteobacteria in the human gut. Our primary outcome was to study the profile of the human fecal microbiome after TBI and the secondary outcome was to identify colonization with colistin-resistant and multidrug-resistant pathogens
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The Effect of Anesthetic Agent and Mean Arterial Pressure on Functional Outcome After General Anesthesia for Endovascular Thrombectomy. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2022-12-07 Danielle Crimmins, Elizabeth Ryan, Darshan Shah, Thar-Nyan Lwin, Steven Ayotte, Kendal Redmond, David Highton
The optimal general anesthetic (GA) technique for stroke patients undergoing endovascular thrombectomy (ET) is unclear. We compared favorable outcomes and mortality in patients receiving propofol or volatile GA during ET and assessed associations between mean arterial pressure (MAP) and outcome.
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Periprocedure Management of Blood Pressure After Acute Ischemic Stroke J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-01-01 Deepak Sharma
The management of acute ischemic stroke primarily revolves around the timely restoration of blood flow (recanalization/reperfusion) in the occluded vessel and maintenance of cerebral perfusion through collaterals before reperfusion. Mechanical thrombectomy is the most effective treatment for acute ischemic stroke due to large vessel occlusions in appropriately selected patients. Judicious management
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Current Recommendations for Perioperative Brain Health: A Scoping Review J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-01-01 Denise J. Wooding, Thalia S. Field, Stephan K.W. Schwarz, Su-Yin MacDonell, Jaycee Farmer, Shobana Rajan, Alana M. Flexman
Perioperative complications such as stroke, delirium, and neurocognitive dysfunction are common and responsible for increased morbidity and mortality. Our objective was to characterize and synthesize the contemporary guidelines on perioperative brain health for noncardiac, non-neurologic surgery in a scoping review. We performed a structured search for articles providing recommendations on brain health
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Frailty Assessment and Prehabilitation Before Complex Spine Surgery in Patients With Degenerative Spine Disease: A Narrative Review J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-01-01 Basma Mohamed, Ramani Ramachandran, Ferenc Rabai, Catherine C. Price, Adam Polifka, Daniel Hoh, Christoph N. Seubert
Degenerative spine disease increases in prevalence and may become debilitating as people age. Complex spine surgery may offer relief but becomes riskier with age. Efforts to lessen the physiological impact of surgery through minimally invasive techniques and enhanced recovery programs mitigate risk only after the decision for surgery. Frailty assessments outperform traditional tools of perioperative
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Anesthesia, Blood Pressure, and Socioeconomic Status in Endovascular Thrombectomy for Acute Stroke: A Single Center Retrospective Case Cohort J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-01-01 Amie L. Hoefnagel, Joyce Yao, Dinesh Rao, Peter Kovacs, Grzegorz Brzezicki, Paul D. Mongan
Introduction: Mechanical thrombectomy (MT) is standard for acute ischemic stroke (AIS), with early studies suggesting that general anesthesia (GA) is associated with worse outcomes than monitored anesthesia care (MAC). Socioeconomic deprivation is also a risk factor for worse AIS outcomes. With improvements in MT and blood pressure (BP) management, it remains unclear if GA or socioeconomic deprivation
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Comparison of Equiosmolar Doses of 7.5% Hypertonic Saline and 20% Mannitol on Cerebral Oxygenation Status and Release of Brain Injury Markers During Supratentorial Craniotomy: A Randomized Controlled Trial J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-01-01 Georgia G. Tsaousi, Ioakeim Pezikoglou, Anastasia Nikopoulou, Nicolaos G. Foroglou, Aikaterina Poulopoulou, Timoleon-Achilleas Vyzantiadis, Dimitrios Vasilakos
Background: Hyperosmolar therapy is the mainstay of treatment to reduce brain bulk and optimize surgical exposure during craniotomy. This study investigated the effect of equiosmolar doses of 7.5% hypertonic saline (HTS) and 20% mannitol on intraoperative cerebral oxygenation and metabolic status, systemic hemodynamics, brain relaxation, markers of cerebral injury, and perioperative craniotomy outcomes
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The Influence of Carbon Dioxide on Cerebral Autoregulation During Sevoflurane-based Anesthesia in Patients With Type 2 Diabetes J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2023-01-01 Rokus E.C. van den Dool, Rogier V. Immink, Björn J.P. van der Ster, Jeroen Hermanides, Markus W. Hollmann, Benedikt Preckel, Johannes J. van Lieshout, Nicolaas H. Sperna Weiland
Background: Cerebral autoregulation (CA) continuously adjusts cerebrovascular resistance to maintain cerebral blood flow (CBF) constant despite changes in blood pressure. Also, CBF is proportional to changes in arterial carbon dioxide (CO2) (cerebrovascular CO2 reactivity). Hypercapnia elicits cerebral vasodilation that attenuates CA efficacy, while hypocapnia produces cerebral vasoconstriction that
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Variability in Resource Utilization in the Evaluation and Management of Simple Febrile Seizures Inpatients in US Children's Hospitals. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2022-12-06 Dane Saksa, Lena S Sun, Jonathan Rodean, Jay Berry, Matt Hall, Izabela Leahy, Lynne Ferrari, Yolanda Y Huang
To characterize resource utilization in the evaluation and treatment of hospitalized simple febrile seizure (SFS) patients in US tertiary pediatric hospitals.
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Impact of Anesthetic Exposures on the Neurocognitive Profiles of Pediatric Brain Tumor Survivors: A New Direction for Research and Multidisciplinary Collaboration. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2022-12-06 Lisa Eisler, William M Jackson, Lena S Sun, Stephen A Sands
Primary brain tumors are the most commonly diagnosed solid tumors in children, and pediatric brain tumor survivors experience lasting, pervasive deficits of neurocognitive functioning. Repeated exposure to anesthetic drugs is a necessary component not only of surgical resection but also of multimodal cancer care for the youngest patients with brain tumors. The potential for anesthetic neurotoxicity
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Lessons Learned in Neurodevelopmental Outcomes Research in Children Following Extracorporeal Membrane Oxygenation. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2022-12-06 Matthew Monteleone, Cynthia Salorio
Neurodevelopmental outcomes research in children following extracorporeal membrane oxygenationis a complex and evolving field. From systematic reviews to multi-center prospective cohort studies, a variety of research endeavors in this domain have already been conducted. Recent attention has redirected the focus on biomarkers and imaging studies to help better understand the neurological, developmental
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Perinatal Anesthesia Exposure and Autism Spectrum Disorders. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2022-12-06 Philipp Houck, Claire Naus, Lisa Croen, Lena S Sun
Epidural analgesia is frequently used during labor among pregnant people in the United States. Different factors have been associated with the development of autism spectrum disorder in the epidemiological literature: maternal health, infectious and pharmacological etiologies, social factors, and environmental exposures. Current data indicates no clear association between the use of epidural labor
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General Anesthesia and the Premature Baby: Identifying Risks for Poor Neurodevelopmental Outcomes. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2022-12-06 Jerri C Price, Susan Lei, Thomas G Diacovo
Preterm birth affects 1 in every 10 infants born in the United States. Importantly, more preterm infants are surviving to discharge from hospital, including those born at the cusp of viability (eg, 22 to 24 wk gestation). Such improvements, however, come at a cost as those delivered at less than 28 weeks gestation have the highest rates of morbidity and mortality. To complicate matters, these extremely
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Memory Problems in Children With Congenital Heart Disease: A Narrative Review. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2022-12-06 William M Jackson, Matthew Monteleone, An Kim, Riva Ko
Care for congenital heart diseases (CHD) has improved significantly over the past several decades, and children with CHD are now surviving into adulthood. Cognitive and behavioral problems affect children with CHD more than healthy peers. A review of performance on neuropsychological memory tasks has not been reported. We aimed to summarize the published literature on memory problems in people with
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Prenatal Opioid Exposure and Neurodevelopmental Outcomes. J. Neurosurg. Anesthesiol. (IF 3.7) Pub Date : 2022-12-06 Jennifer J Lee, Neeta Saraiya, Michael W Kuzniewicz
The opioid epidemic in the United States has resulted in a significant increase in opioid use disorder among pregnant women and a concomitant increase in the incidence of neonatal opioid withdrawal syndrome. The long-term consequences of prenatal opioid exposure on neurodevelopmental outcomes are not fully understood. Animal studies indicate increased neuronal apoptosis and decreased neuronal proliferation