Abstract:
BACKGROUND:Positional change during general anesthesia can cause hypotension. The objective of this retrospective study was to determine predictive factors for hypotension associated with supine-to-prone positional change in spinal surgery patients. MATERIALS AND METHODS:Data on demographics, current medications, comorbidity, intraoperative mean arterial pressure (MAP), heart rate, pulse pressure variation, tidal volume, peak inspiratory pressure, and propofol and remifentanil effect-site concentrations were collected from 179 patients undergoing elective spine surgery. Hypotension associated with supine-to-prone positional change was defined as >20% reduction in MAP during positional change. RESULTS:Hypotension associated with supine-to-prone positional change was observed in 16 (8.9%) patients. The median (interquartile range) effect-site concentration of remifentanil (5.3 [4.0 to 8.5] vs. 4.0 [3.1 to 4.0] ng/mL, P<0.001), MAP (95.0 [86.0 to 103.5] vs. 80.0 [70.0 to 94.0] mm Hg, P=0.014), peak inspiratory pressure (16.5 [15.0 to 18.5] vs. 15.0 [14.0 to 17.0] hPa, P=0.040) in the supine position, and pulse pressure variation in the prone position (12.0 [9.0 to 16.4] vs. 9.0 [7.0 to 12.0]%, P=0.019) were significantly higher in the hypotension group. In multivariate logistic regression analysis, the effect-site concentration of remifentanil (odd ratio [95% confidence interval], 2.12 [1.51-2.96], P<0.001), preoperative use of beta-blocker (7.64 [1.21-48.36], P=0.031), and MAP in the supine position (1.04 [1.00-1.07], P=0.033) were independent predictive factors for hypotension associated with supine-to-prone positional change. CONCLUSIONS:Increased effect-site concentration of remifentanil, preoperative use of beta-blocker, and high MAP in the supine position were predictive factors for hypotension associated with supine-to-prone positional change in spinal surgery patients.
journal_name
J Neurosurg Anesthesioljournal_title
Journal of neurosurgical anesthesiologyauthors
Yoon HK,Lee HC,Chung J,Park HPdoi
10.1097/ANA.0000000000000565subject
Has Abstractpub_date
2020-04-01 00:00:00pages
140-146issue
2eissn
0898-4921issn
1537-1921pii
00008506-202004000-00007journal_volume
32pub_type
杂志文章abstract::Because deliberate hypothermia is becoming commonly used during neurosurgery, this study was performed to investigate the effects of a progressive reduction of body core temperature (T) on whole body oxygenation variables in patients undergoing elective intracranial surgery. In 13 patients (Hypothermic Group), T was r...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00008506-199707000-00001
更新日期:1997-07-01 00:00:00
abstract::Inflammatory response with cytokine release is reported to correlate with clinical outcome after aneurysmal subarachnoid hemorrhage (SAH). In selected cases, hypothermia and barbiturate coma are applied as means for neuroprotection after severe SAH. Hypothermia and high-dose barbiturate are reported to attenuate the i...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0b013e31817996bf
更新日期:2008-07-01 00:00:00
abstract::Intraoperative brain surface electrocorticography (ECoG) is an integral part of the surgical excision of epileptogenic foci. If surgical excision is performed under general anesthesia, anesthetics should be selected that do not seriously interfere with the ECoG. We report a case where nitrous oxide appeared to suppres...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:
更新日期:1990-09-01 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: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: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: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::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::Acute respiratory distress syndrome is commonly encountered in head-injured patients. Positive and expiratory pressure (PEEP) is useful in improving oxygenation. However, PEEP, by increasing intrathoracic pressure, decreases venous return, mean arterial pressure, and cardiac output and increases jugular vein pressure....
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199704000-00013
更新日期:1997-04-01 00:00:00
abstract::In a rat model of middle cerebral artery occlusion (MCAo) and reperfusion (120 min), previous studies have demonstrated that hemodilution with molecular hemoglobin decreases ischemic brain injury. However, long-term recovery data on the therapeutic efficacy of molecular hemoglobin for cerebral ischemia are lacking. Ac...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract::Clearance of valproic acid from brain tissue is believed to occur via a carrier-mediated system(s). The present study was designed to determine whether clearance was capacity-limited (saturable) and whether it occurred primarily at the choroid plexus. Ten rabbits were anesthetized with halothane and surgically prepare...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199407000-00008
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:Cognitive training is beneficial in various clinical settings, although its perioperative feasibility and impact remain unknown. The objective of this pilot study was to determine the feasibility of home-based cognitive prehabilitation before major surgery in older adults. MATERIALS AND METHODS:Sixty-one pa...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ANA.0000000000000569
更新日期:2019-04-01 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::We report our experience with anesthetic care for six patients with pseudoankylosis of the mandible following neurosurgical procedures, four of whom required fiberoptically guided intubation for anesthesia. We suggest that the development of operative approaches and reconstruction techniques in skull base surgery may ...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00008506-199507000-00005
更新日期:1995-07-01 00:00:00
abstract::The authors report an acute epidural hematoma after the surgical removal of a cervical C6-C7 disc herniation through an anterolateral approach of the cervical spine. Clinical history consisted of respiratory distress and flaccid tetraplegia that appeared 2.5 hours after surgery. Without any complementary radiologic in...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-200307000-00020
更新日期:2003-07-01 00:00:00
abstract::The trigeminocardiac reflex is a well-described brainstem reflex that clinically manifests as bradycardia, hypotension, or apnea. This physiological phenomenon is extensively reported during open neurosurgical procedures, but very few data exist for trigeminocardiac reflex occurrence during neurointerventional procedu...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000723
更新日期:2020-08-28 00:00:00
abstract::We evaluated the optimal preemptive dose of gabapentin for postoperative pain relief after single-level lumbar diskectomy and its effect on fentanyl consumption during the initial 24 hours in a randomized, double-blinded, placebo-controlled study in 100 patients with American Society of Anesthesiologists physical stat...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.ana.0000151407.62650.51
更新日期:2005-04-01 00:00:00
abstract::The effect of the calcium blocker nimodipine on the cerebral blood flow (CBF) and cerebral autoregulatory responses was examined in seven fentanyl/N2O/anesthetized pigs. CBF was measured continuously from the sagittal sinus by a venous outlet flow technique. Cerebral autoregulation tests were performed before, after 3...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199404000-00007
更新日期:1994-04-01 00:00:00
abstract::Functional neurosurgery has undergone rapid growth over the last few years fueled by advances in imaging technology and novel treatment modalities. These advances have led to new surgical treatments using minimally invasive and precise techniques for conditions such as Parkinson's disease, essential tremor, epilepsy, ...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/ANA.0000000000000398
更新日期:2018-01-01 00:00:00
abstract::Disseminated intravascular coagulation (DIC) is reported in neurosurgical patients; however, the incidence of DIC after craniotomy procedures is unknown. Using a surgical database, we identified 3164 patients who underwent primary craniotomy at Mayo Clinic Rochester between January 1, 2000 and December 31, 2004. Poten...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0b013e318155b1c4
更新日期:2008-01-01 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::On April 16 and 17, 2016, the Fifth biennial Pediatric Anesthesia & Neurodevelopment Assessment (PANDA) symposium was convened at the Morgan Stanley Children's Hospital of New York at Columbia University Medical Center. During the symposium, experts in the fields of anesthesiology, neuropsychology, and epidemiology we...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000350
更新日期:2016-10-01 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::Although cerebral monitoring during CPB remains primarily investigational, recent data support its clinical utility. In particular, it is cerebral metabolic monitoring that provides meaningful information in terms of preparing the brain for dhCPB and dhCA. Cerebral blood flow or cerebral blood flow velocity monitoring...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/00008506-199307000-00022
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND:The sitting position has potential for serious complications such as cerebral ischemia and venous air embolism. This study investigated the effects of intermittent sequential compression device (SCD) on the changes in regional cerebral oxygen saturation (rSO2) during the sitting position. METHODS:Sixty-six ...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ANA.0b013e3181e97a5e
更新日期:2011-01-01 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::Intra-arterial vasodilators, such as papaverine, have been used to treat cerebrovascular insufficiency. The short biologic half-life, and the vasodilating and neuroprotective properties of adenosine could be useful during the treatment of cerebral ischemia. However, in human subjects a proposed intracarotid dose of 1 ...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-200204000-00004
更新日期:2002-04-01 00:00:00
abstract::The use of direct oral anticoagulants is increasing rapidly, because of perceived benefits over older agents, such as predictable pharmacokinetics and a reduced risk of bleeding. Elderly patients, who are more likely to be prescribed these drugs, are also presenting for neurosurgical procedures more often. The combina...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/ANA.0000000000000629
更新日期:2020-10-01 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::Translocation of cerebrospinal fluid (CSF) between the intracranial and spinal subarachnoid space was blocked by ligating the cervical spinal core in eight cats under pentobarbital and nitrous oxide anesthesia, and the effects of cerebral venous congestion on the pressure-volume index (PVI), a measure relating the cha...
journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
doi:10.1097/00008506-199304000-00009
更新日期:1993-04-01 00:00:00