Acute Cerebrovascular Conditions · Coagulopathy and Bleeding · Intracerebral Haemorrhage · Pharmacology · Subarachnoid Haemorrhage

TICH-2: No Benefit From TXA in ICH. What Now?

Tranexamic acid (TXA) has been held as something of a wonder drug. It’s cheap, largely demonstrated to be safe and has been given a role in a number of settings. The 2013 CRASH-2 trial showed improved survival in trauma with bleeding, and thus became one of the most widely cited publications in traumatology and emergency medicine. Several… Continue reading TICH-2: No Benefit From TXA in ICH. What Now?

Acute Cerebrovascular Conditions · Anaesthetic Agents · Ischaemic Stroke · Neuroanaesthesia · Sedation

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?

Acute Cerebrovascular Conditions · European Guidelines · Fluid Management · Haemodynamics · Osmotherapy · Subarachnoid Haemorrhage · Traumatic Brain Injury

Fluid Therapy in Neurointensive Care patients – An ESICM Recommendation

Just published: the European Society of Intensive Care Medicine´s consensus document on fluid administration in the NICU. It covers all manner of neurocritical conditions and sums up the available evidence for various fluid therapy approaches. As expected there are few recommendations that aren´t already well established and by now fairly uncontroversial (multimodal monitoring, avoiding colloids,… Continue reading Fluid Therapy in Neurointensive Care patients – An ESICM Recommendation

Analgaesia · Cervical Spine Surgery · Neuroanaesthesia · Perioperative Management · Pharmacology · Thoracolumbar Spine Surgery

Gabapentin and Spinal Surgery – a Meta-analysis

Christmas and New Years is usually fairly dormant in terms of publications, but a few worth mentioning have surfaced. This recent meta-analysis of gabapentin as an analgaesic adjunct in spinal surgery was published in Pain Physician by Han et al. The group included 10 trials, covering 827 patients, and found significantly reduced postoperative morphine consumption,… Continue reading Gabapentin and Spinal Surgery – a Meta-analysis

General Topics · Neuroanaesthesia

Elevated serum lactate during craniotomies…

In the last issue of Journal of neurosurgical anesthesiology, there is an interesting article discussing elevated serum lactate during craniotomies. Brallier et al performed a retrospective cohort study of elective adult craniotomy cases (436 patients). They found that elevated intraoperative serum lactate in craniotomy patients is associated with new neurological deficits (odds ratio, 2.11) and longer length… Continue reading Elevated serum lactate during craniotomies…

Anaesthetic Agents · Awake Craniotomy · Neuroanaesthesia · Sedation

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