Sedation in Acute Brain Injury
Excellent and widely read overview of sedation regimes in acute brain injury. Find the article by Oddo et al in Critical Care here.
Category: Anaesthetic Agents
Anaesthesia for Endovascular Treatment of Acute Ischaemic Stroke: Still Controversial?
A recently published review [1] by our Danish colleagues sums up the more recent trials on the subject of anaesthetic technique for endovascular treatments of ischaemic stroke. Previous publications, many of which are based largely on observational or retrospective data, have suggested harm from general anaesthesia (GA) for these procedures, when compared with conscious sedation… Continue reading Anaesthesia for Endovascular Treatment of Acute Ischaemic Stroke: Still Controversial?
Awake Craniotomy: Useful Resources
Here’s a few resources on anaesthesia for awake craniotomies that have recently come to our attention, thanks to some of our colleagues: The first, from UpToDate, was updated this year. The second is part of the British Journal of Anaesthesia’s Continuing Education in Anaesthesia Critical Care & Pain series. It dates back to 2013 but is still… Continue reading Awake Craniotomy: Useful Resources
AnStroke Trial: Anaesthesia vs. Sedation for Endovascular Treatment of Ischemic Stroke
Does choice of anaesthetic approach have an impact on neurological outcomes in stroke patients? This article, recently published in Stroke, examines outcomes in patients undergoing endovascular treatment for acute ischemic stroke, randomised to either conscious sedation or general anaesthesia. Retrospective material till now has suggested poorer outcomes in patients subjected to full anaesthesia when compared… Continue reading AnStroke Trial: Anaesthesia vs. Sedation for Endovascular Treatment of Ischemic Stroke
LITFL – Ketamine in Head Injured Patients
Life in The Fast Lane´s take on the use of ketamine in traumatic brain injury. Nice summary of available literature. Sums it up succinctly for those who are still reluctant to use ketamine in this patient group. For more on the same subject, see this article on ketamine and ICP.
Roc or Sux in RSI of TBI Patients?
Retrospective cohort study by Patanwala and colleagues including 233 head injured patients that required RSI with either rocuronium or suxamethonium. The results reveal that sux was associated with increased mortality in the most severely injured subset, compared with roc. In patients with less severe injury there was no significant difference between the two NMBs. Interesting… Continue reading Roc or Sux in RSI of TBI Patients?
Update on anesthetic neuroprotection
“The evidence of benefit of current strategies remains sparse.” Zwerus et al, The Netherlands. Current Opinions in Anesthesiology, 2015 Aug. Read abstract from the article here.
Ketamine and ICP.
We can use ketamine in patients with traumatic brain injury… The ketamine effect on ICP in traumatic brain injury. Zeiler et al, Canada. Neurocritical Care, 2014 Aug. Access the abstract here.
Cochrane Review – Barbiturates for acute traumatic brain injury
The latest version of a Cochrane review of barbiturate therapy for ICP-management. “There is no evidence that barbiturate therapy in patients with acute severe head injury improves outcome. Barbiturate therapy results in a fall in blood pressure in one in four patients. This hypotensive effect will offset any ICP lowering effect on cerebral perfusion pressure”… Continue reading Cochrane Review – Barbiturates for acute traumatic brain injury
neuroscand.com 