Abstract:
STUDY DESIGN:A prospective, randomized study in a large general hospital setting. BACKGROUND:During spinal surgery, monitoring motor-evoked potentials (MEPs) is a means of assessing the intraoperative integrity of corticospinal pathways. However, MEPs are known to be sensitive to the effects of anesthetic agents. OBJECTIVE:To compare the use of desflurane or total intravenous anesthetic regimens (TIVA) with multipulse cortical stimulation for intraoperative monitoring (IOM). METHODS:Twenty consecutive patients (10 in each arm) undergoing scoliosis correction surgery were randomly assigned to 2 equal groups receiving desflurane or TIVA. Inhalational anesthesia was maintained using 66% nitrous oxide in oxygen and a mean end-tidal desflurane concentration of 3.4%. For TIVA, continuous intravenous infusion of propofol was used. For analgesia, fentanyl and morphine were given when required for both groups. Cortical stimulation was achieved with 2 bipolar direct current stimulators connected in parallel by jumper cables. Five equivalent pulses 0.5 ms in duration at 4 ms intervals were delivered at C1C2 positions. MEP recordings were made in the abductor hallucis (AH) and tibialis anterior (TA) with needle electrodes. RESULTS:Reproducible MEPs were obtained throughout the operation in all 20 cases, with up to 80 mA per stimulator. Before insertion of pedicle screws, mean MEP amplitudes (SD) obtained were 85 (19) and 21.7 (10.8) mV for AH and TA, respectively, using desflurane. With TIVA, amplitudes were 56.7 (28.4) and 59.1 (24.5) mV, respectively. Both muscle MEP amplitudes were significantly different using different anesthetic regimens (P < 0.05 for all). AH MEP amplitudes obtained with desflurane were significantly larger than TA amplitudes (P < 0.0001). No complications were reported intraoperatively and postoperatively. CONCLUSIONS:This is the first study comparing the use of desflurane and TIVA showing that both anesthetic regimens allowed successful intraoperative monitoring useage throughout the procedures. For MEP recording, the AH was the preferred muscle with a desflurane anesthetic regimen.
journal_name
J Neurosurg Anesthesioljournal_title
Journal of neurosurgical anesthesiologyauthors
Lo YL,Dan YF,Tan YE,Nurjannah S,Tan SB,Tan CT,Raman Sdoi
10.1097/01.ana.0000211007.94269.50subject
Has Abstractpub_date
2006-07-01 00:00:00pages
211-4issue
3eissn
0898-4921issn
1537-1921pii
00008506-200607000-00009journal_volume
18pub_type
杂志文章,随机对照试验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
abstract::Seizures are a common occurrence in the intensive care unit (ICU). The presentation of seizures is usually as focal or generalized motor convulsions, but other seizure types may occur. Etiologies of the seizures are typically secondary either to primary neurologic pathology or a consequence of critical illness and cli...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/00008506-200104000-00016
更新日期:2001-04-01 00:00:00
abstract::The cause of the awareness under general anesthesia often cannot be definitely determined from retrospective reviews of handwritten records, examinations of equipment, or interviews with clinicians. Failure to deliver the intended concentrations of anesthetic agents to the patient is one possible contributing cause fo...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0b013e318139f7df
更新日期:2007-10-01 00:00:00
abstract::It has been suggested that N2O may alter the sensitivity of the brain to ischemia. To test this hypothesis. we examined the effects of N2O on the development of left-right hemispheric asymmetry in the electroencephalogram (EEG) during hemorrhagic hypotension in rats subjected to unilateral carotid occlusion. Rats were...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-198906000-00004
更新日期:1989-06-01 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:BACKGROUND:Hemodynamic instability and cardiovascular events heavily affect the prognosis of traumatic brain injury. Physiological signals are monitored to detect these events. However, the signals are often riddled with faulty readings, which jeopardize the reliability of the clinical parameters obtained from the sign...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000462
更新日期:2018-10-01 00:00:00
abstract::Obstructive hydrocephalus remains a problem, and improvements in fiberoptic technology have promoted interest in neuroendoscopic ventriculostomy (NTV) as an alternative to standard cerebrospinal fluid shunts. The present study assessed 210 pediatric NTVs performed between 1994 and 2004 in patients aged 2 months to 10 ...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:
更新日期:2005-01-01 00:00:00
abstract::The function of the central nervous system-and other organs-depends upon preservation of ionic gradients across cell membranes. In nervous tissue, the ion gradients are especially important since generation of action potentials and synaptic processes relies on transfer of ions across the plasma membrane. This report d...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-198912000-00010
更新日期:1989-12-01 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::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:Hemodynamic instability is commonly seen during carotid angioplasty and stenting. Although prophylactic treatment with anticholinergics is beneficial, selected use in high-risk patients is desirable. This study examines whether plaque characteristics on computed tomography angiography in addition to demograp...
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::This study was designed to investigate the incidence and clinical consequences of hemidiaphragmatic paresis in patients undergoing carotid endarterectomy using cervical plexus block anesthesia. In 28 patients, diaphragmatic motion was evaluated by fluoroscopy 20 min after cervical plexus block with 1% mepivacaine. In ...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199401000-00003
更新日期:1994-01-01 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::The relationship between intracranial pressure and arterial blood pressure during sevoflurane or halothane anesthesia was evaluated in New Zealand white rabbits after cryogenic brain injury. Fourteen rabbits were randomized to be anesthetized with 1.5 MAC of sevoflurane or halothane in oxygen. All animals were paralyz...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199410000-00006
更新日期:1994-10-01 00:00:00
abstract:BACKGROUND:Anesthetic modality and hemodynamic management during mechanical thrombectomy (MT) for acute ischemic stroke (AIS) are potential contributors to the success of revascularization. The aims of our study were to review the hemodynamic management by anesthesiologists and clinical outcomes in patients undergoing ...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000514
更新日期:2019-07-01 00:00:00
abstract::Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, is widely used in pediatric anesthesia. Recently, a series of animal studies have shown that ketamine may have neurotoxic effects on the developing brain and that these effects can later cause neurofunctional impairment. However, other studies have also sho...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/ANA.0000000000000027
更新日期:2014-04-01 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 affect of L-644,711, an anion transport inhibitor, on ischemic brain injury and edema was investigated. Spontaneously hypertensive rats were given one of the following doses of intrathecal L-644,711 during 180 min of middle cerebral artery occlusion and 120 min of reperfusion: control, vehicle only; dose I, 100 mi...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199112000-00003
更新日期:1991-12-01 00:00:00
abstract:BACKGROUND:Neonatal mice exposed to sevoflurane show certain cognitive and behavioral impairments in adulthood. However, the mechanisms underlying long-term cognitive deficits induced by sevoflurane exposure remain unknown. The present study was performed to investigate whether there is differential neuronal activation...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000387
更新日期:2018-01-01 00:00:00
abstract::Using a rabbit model of intracranial hypertension, we studied the effects of infusion of phenylephrine on intracranial pressure (ICP) and cerebral perfusion pressure (CPP). Seven New Zealand white rabbits were anesthetized with isoflurane and normocapnia was maintained. An extradural balloon was used to raise ICP to 2...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-200201000-00006
更新日期:2002-01-01 00:00:00
abstract::Olprinone is a promising new drug used for treating cerebral vasospasm. To clarify the effects of olprinone on systemic and cerebral circulation in patients with subarachnoid hemorrhage, hemodynamic and oxygenation parameters were evaluated as 12 such patients underwent surgery. After aneurysm clipping and confirmatio...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00008506-200004000-00002
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:We compared the effect of propofol and sevoflurane combined with remifentanil under comparable bispectral index (BIS) levels on transcranial electric motor-evoked potentials (TceMEPs) and somatosensory-evoked potentials (SSEPs) during brainstem surgery. MATERIALS AND METHODS:A total of 40 consecutive patien...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ANA.0000000000000157
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
abstract::We describe a case of subarachnoid hemorrhage (SAH) complicated by acute respiratory distress syndrome (ARDS) and cerebral vasospasm. Inhaled nitric oxide (NO) was used to improve oxygenation, thereby facilitating cerebral aneurysm clipping. ...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199904000-00009
更新日期:1999-04-01 00:00:00
abstract::Recently, the enzyme cyclooxygenase (COX) has been recognized to exist as constitutive (COX-1) and inducible isoforms (COX-2). In previous studies, drugs that were inhibitors of both COX-1 and COX-2 failed to decrease brain edema formation or improve Neurological Severity Score (NSS) after closed head trauma (CHT), al...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-200001000-00009
更新日期:2000-01-01 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::This report describes a sudden decrease in blood pressure after conservative treatment of acute intracranial hypertension. A 63-year-old woman with acute hydrocephalus after undergoing clipping of an aneurysm of the right supracerebellar artery developed increased intracranial pressure, necessitating surgical manageme...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199804000-00008
更新日期:1998-04-01 00:00:00
abstract::Episodes of arterial hypotension are associated with an increased mortality in head injury patients. Rapid infusion of sodium bicarbonate in such patients may cause hypotension and elevate intracranial pressure. Therefore, we examined the effects of tromethamine (THAM) versus bicarbonate on intracranial pressure and b...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199407000-00009
更新日期:1994-07-01 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: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