Abstract:
:Dexamethasone, a corticosteroid used to treat cerebral edema, is known to produce elevations in the blood glucose concentration, but the effect of a single intraoperative dose of dexamethasone on the blood glucose concentration is unknown. Glucose concentrations in response to either a 10-mg intravenous bolus of dexamethasone or a saline placebo were evaluated in nondiabetic patients undergoing elective craniotomy. Both arterial and venous blood glucose concentrations were obtained immediately before and after treatment and hourly for 4 hours intraoperatively. The arterial blood glucose concentration in those who received 10 mg dexamethasone (n = 10) increased from 97 +/-15 mg/dL (mean +/- SD) to 149 +/- 23 mg/dL over the course of the study, compared with a change from 88 +/- 11 mg/dL to 103+/-12 mg/dL in those who received placebo (n = 10) (P < 0.05 for 4-hour sample vs. baseline for both groups; P < 0.05 between groups at 4 hours). Further, venous blood glucose concentrations were highly predictive of arterial glucose values (R = 0.98; P < 0.001). Since elevations in the blood glucose concentration should be avoided in the setting of central nervous system ischemia, findings from this investigation suggest that contemplated corticosteroid use should be reviewed for appropriateness of treatment. If dexamethasone is used, even as a single dose during craniotomy, intraoperative blood glucose concentrations should be carefully monitored and hyperglycemia treated, particularly in patients at risk for glucose-mediated exacerbation of brain injury.
journal_name
J Neurosurg Anesthesioljournal_title
Journal of neurosurgical anesthesiologyauthors
Pasternak JJ,McGregor DG,Lanier WLdoi
10.1097/00008506-200404000-00003subject
Has Abstractpub_date
2004-04-01 00:00:00pages
122-5issue
2eissn
0898-4921issn
1537-1921pii
00008506-200404000-00003journal_volume
16pub_type
临床试验,杂志文章abstract:BACKGROUND:Propofol's potential to trigger generalized tonic-clonic seizures and epileptic discharges is still controversial. The aim of this study was to investigate the incidence of epileptic discharges and epileptic seizures in epilepsy patients anesthetized with propofol. METHODS:Thirty three patients with intract...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0b013e3181ff6024
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:Simple febrile seizure (SFS) affects 2% to 4% of children under 6 years of age. The purpose of this study is to examine the epidemiologic patterns and resource utilization of SFS-associated hospitalizations in children aged younger than 6 years of age in the United States. MATERIALS AND METHODS:This study i...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000546
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:The main target site of action for the sedative clonidine (CLO), an α2 adrenoceptor agonist, has been considered to be the locus coeruleus (LC). However, previous reports suggest other sites of action of CLO than the LC. Our previous studies suggested that the neuronal activities in the perifornical area (Pe...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0b013e3182978ff0
更新日期:2013-10-01 00:00:00
abstract::Cerebral air embolism occurred in a patient undergoing posterior fossa surgery performed in the sitting position for acoustic neuroma removal. The patient experienced two episodes of venous air embolism, as evidenced by precordial Doppler, end-tidal carbon dioxide reduction, and oxygen desaturation. In both cases, air...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199601000-00008
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Prone positioning and positive end-expiratory pressure can improve pulmonary gas exchange and respiratory mechanics. However, they may be associated with the development of intracranial hypertension. Intracranial pressure (ICP) can be noninvasively estimated from the sonographic measurement of the optic nerv...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000295
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Postoperative nausea and vomiting (PONV) are frequent and harmful complications after neurosurgery. Current pharmacy-based treatment is the standard of care; it, however, lacks efficiency. Invasive and noninvasive acupuncture at the P6 meridian point has been shown to be effective in the prevention of PONV. ...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ANA.0b013e31825eb5ef
更新日期:2012-10-01 00:00:00
abstract::The effects of flumazenil (a benzodiazepine antagonist) on autoregulation of cerebral blood flow (CBF) were examined in dogs receiving midazolam and in dogs not receiving midazolam. Both groups were anesthetized with halothane (0.3% end-expired) and nitrous oxide (66%) in oxygen. Auto-regulation of CBF was assessed by...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-198909000-00006
更新日期:1989-09-01 00:00:00
abstract:BACKGROUND:In patients with severe brain injury, endotracheal suctioning (ETS) can increase intracranial pressure (ICP) and reduce cerebral perfusion pressure (CPP). The aim of this prospective, blinded clinical trial was to assess the effectiveness of aerosolized lidocaine to prevent increase of ICP induced by ETS in ...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0b013e31826a75b1
更新日期:2013-01-01 00:00:00
abstract::Cerebral oximeter based on near-infrared spectroscopy has been used as a continuous, noninvasive monitoring of regional cerebral oxygen saturation (rSO2). Although the absolute rSO2 values have a wide range of variability, the factors affecting a variability of rSO2 values have not been extensively investigated. The a...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-200310000-00002
更新日期:2003-10-01 00:00:00
abstract::The "Lund concept" involving a "volume-targeted" strategy for intracranial pressure control originated in the University of Lund, Sweden, more than 20 years ago and has remained controversial ever since. It is based on the premise that the blood-brain barrier is disrupted after traumatic brain injury and cerebral auto...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/01.ana.0000405613.27980.ea
更新日期:2011-10-01 00:00:00
abstract::Motor evoked potentials (MEPs) after transcranial magnetic stimulation (TMS) have been examined in 12 monkeys under neuroleptanalgesia (NLA). Compound muscle action potentials were recorded from abductor policis brevis (APB) and gastroncnemius (GN) muscles contralateral to the stimulation site. After obtaining baselin...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199106000-00006
更新日期:1991-06-01 00:00:00
abstract::Brain tissue oxygen monitoring (P(ti)O2 (Neurotrend, Codman, Germany) was employed in addition to standard intracranial pressure (ICP) and cerebral perfusion pressure (CPP) monitoring in seven patients with severe neuronal damage of heterogeneous etiology. The correlation between P(ti)O2 changes and CPP fluctuations d...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00008506-200301000-00006
更新日期:2003-01-01 00:00:00
abstract::The purpose of this study was to clarify whether prostaglandin E1 (PGE(1)) or corticosteroid could increase blood flow in the nerve root because neurologic symptoms in spinal stenosis may be based on the vascular insufficiency in the nerve root. Fifty-seven patients undergoing lumbar diskectomy were randomly assigned ...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00008506-200304000-00002
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:Appropriate placement of the bispectral index (BIS)-vista montage for frontal approach neurosurgical procedures is a neuromonitoring challenge. The standard bifrontal application interferes with the operative field; yet to date, no other placements have demonstrated good agreement. The purpose of our study w...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0b013e31826ca3a0
更新日期:2013-04-01 00:00:00
abstract::We report an unusual case of fatal intracranial hypertension following tracheostomy due to the obstruction of the internal jugular veins (left side: thrombosis after central venous cannulation, right side: hypoplastic vein) and their collaterals. Principal cerebral outflow through the internal jugular veins can be sub...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-200210000-00008
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Preincisional and postoperative transcutaneous electrical nerve stimulation (TENS) administration reduces postoperative opioid demand in abdominal surgery. Aim of this study was to find out whether a comparable effect of TENS applies in major spinal surgery. METHODS:Thirty-eight patients of bo...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ANA.0b013e3181b7fef5
更新日期:2010-01-01 00:00:00
abstract::We provide a synopsis of innovative research, recurring themes, and novel experimental findings pertinent to the care of neurosurgical patients and critically ill patients with neurological diseases. We cover the following broad topics: general neurosurgery, spine surgery, stroke, traumatic brain injury, monitoring, a...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/ANA.0000000000000489
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Remifentanil is an ultrashort-acting µ-opioid receptor agonist and is especially suitable for neuroanesthesia. We previously reported that general anesthesia with remifentanil for brain tumor resection was associated with lower postoperative mortality and shorter postoperative length of stay (LOS) when compa...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000039
更新日期:2014-10-01 00:00:00
abstract::A case of two incidental familial intracranial aneurysms associated with asymptomatic coarctation of the aorta is reported. Priority was assigned to aneurysm surgery, which was accomplished by means of two distinct procedures, both requiring moderate, deliberate hypotension. Invasive monitoring always included radial ...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199301000-00008
更新日期:1993-01-01 00:00:00
abstract::In this article anesthesiologic and hematologic aspects of a patient with Hemophilia-A, who underwent craniotomy for a right middle cerebral artery aneurysm, are discussed. ...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199907000-00012
更新日期:1999-07-01 00:00:00
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journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000689
更新日期:2020-05-05 00:00:00
abstract::In patients with lesions of the cervical spine, direct laryngoscopy for endotracheal intubation entails the risk of injuring the spinal cord. In an attempt to avoid this complication, the authors used flexible fiberoptic nasal intubation in a series of 327 patients with cervical lesions undergoing elective neurosurgic...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199901000-00003
更新日期:1999-01-01 00:00:00
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journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0b013e3181de4eae
更新日期:2010-07-01 00:00:00
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journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199807000-00002
更新日期:1998-07-01 00:00:00
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journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-200304000-00012
更新日期:2003-04-01 00:00:00
abstract::Studies on cerebral blood flow during hypotension and high intracranial pressure are scarce. Accordingly, this study examines the effects of increased cerebrospinal fluid (CSF) pressure on the cerebral circulatory response to hemorrhage. Measurements of cerebral microcirculation with laser Doppler flowmetry was perfor...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199801000-00011
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Prolongation of the interval from the peak to the end of the T wave (Tp-Te) on a 12-lead electrocardiogram (ECG) is associated with ventricular arrhythmias. The aim of this study was to clarify associations between Tp-Te, Tp-Te/QT, and Tp-Te/rate-corrected QT (QTc) with clinical severity of subarachnoid hemo...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000624
更新日期:2021-01-01 00:00:00
abstract::We have observed that patients, after retromastoid craniectomy (RMC) with microvascular decompression (MVD) of cranial nerves, frequently experienced postoperative nausea and vomiting (PONV). The authors conducted this study to track the incidence of PONV and to identify potential factors for PONV after RMC with MVD. ...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-200610000-00003
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:Glucocorticoids have been shown to alleviate ischemia-induced myocardial injury, while aggravating neuronal damage caused by ischemia. As energy failure is a predominant factor in cellular viability, we examined the effects of glucocorticoids on energy utilization in the mouse heart and brain. METHODS:Seven...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000153
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Cardiac disease is the leading cause of death in the United States and late-stage heart failure is associated with a high level of morbidity and mortality. The ventricular assist devices and extracorporeal membrane oxygenators are the mainstay of mechanical circulatory support devices for the patients with e...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0b013e3181eee55e
更新日期:2011-01-01 00:00:00