LITFL – Initial Management of SAH
A quick run-through on acute care of subarachnoid haemorrhage patiefnts by the always-relevant Life In The Fast Lane guys.
Category: Neuroanaesthesia
The Potential Benefits of Awake Craniotomy for Brain Tumor Resection: An Anesthesiologist’s Perspective
Nice review article. Meng et al, USA. Journal og Neurosurgical Anesthesiology, 2015 Oct. Abstract available here.
Local anesthetics and awake craniotomy.
“Scalp block with a mixture of lidocaine and ropivacaine seems to provide effective and safe anesthetic management in patients undergoing awake craniotomy.” Comment: Be aware of the doses of local anesthetics that you are using. Efficacy and Safety of a Lidocaine and Ropivacaine Mixture for Scalp Nerve Block and Local Infiltration Anesthesia in Patients Undergoing… Continue reading Local anesthetics and awake craniotomy.
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?
SAH-patients: HyperHaes and reduction in ICP (2004)
“.. infusion of 2 ml kg(-1) during 20 min has a predictable and clinically significant beneficial effect on ICP and CPP.” Predictable reduction of intracranial hypertension with hypertonic saline hydroxyethyl starch: a prospective clinical trial in critically ill patients with subarachnoid hemorrhage. Bentsen et al, Norway. Acta Anaesthesiologica Scandinavica, 2004 Oct. Read the abstract here. Hypertonic… Continue reading SAH-patients: HyperHaes and reduction in ICP (2004)
CEACCP – Posterior Fossa Surgery
Anaesthetic considerations for posterior fossa surgery. A very useful synopsis on the subject. By Sathyanarayanan for Continuing Education in Anaesthesia, Critical Care & Pain. 2013.
From the IHAST Investigators: Effects of intraoperative hypothermia on neuropsychological outcomes after intracranial aneurysm surgery
“There was no difference in the incidence of impairment between hypothermic and normothermic groups” Abstract: Effects of intraoperative hypothermia on neuropsychological outcomes after intracranial aneurysm surgery. Ann Neurol 2006. Anderson et al.
Intraoperative Hypothermia for Aneurysm Surgery Trial (IHAST) Investigators. Mild intraoperative hypothermia during surgery for intracranial aneurysm
Free full-text via PubMed at: Intraoperative Hypothermia for Aneurysm Surgery Trial (IHAST) Investigators. Mild intraoperative hypothermia during surgery for intracranial aneurysm. Todd et al. NEJM 2005. “Intraoperative hypothermia did not improve the neurologic outcome after craniotomy among good-grade patients with aneurysmal subarachnoid haemorrhage”
Adenosine-induced transient asystole for intracranial aneurysm surgery: a retrospective review
“Adenosine cardiac arrest is a relatively novel method for decompression of intracranial aneurysms to facilitate clip application. With appropriate safety precautions, it is a reasonable alternative method when temporary clipping of proximal vessels is not desirable or not possible” Abstract from the Journal of Neurosurgical Anaesthesiology. 2011: Adenosine-induced transient asystole for intracranial aneurysm surgery: a retrospective… Continue reading Adenosine-induced transient asystole for intracranial aneurysm surgery: a retrospective review
Adenosine-induced flow arrest to facilitate intracranial aneurysm clip ligation
Abstract: Bebawy JF, Gupta DK, Bendok BR, Hemmer LB, Zeeni C, Avram MJ, Batjer HH, Koht A. Adenosine-induced flow arrest to facilitate intracranial aneurysm clip ligation: dose-response data and safety profile. Anesth Analg. 2010.
neuroscand.com 