By George A. Mashour, Ehab Farag
The anesthetic issues and techniques serious about the perioperative care of the neurosurgical sufferer are one of the most intricate in anesthesiology. The perform of neurosurgery and neuroanesthesiology contains a wide selection of instances, from significant backbone surgical procedure, to aneurysm clipping and wide awake craniotomy. Case reviews in Neuroanesthesia and Neurocritical Care offers a accomplished view of real-world medical perform. It comprises over ninety case displays with accompanying focussed discussions, protecting the large diversity of approaches and tracking protocols concerned about the care of the neurosurgical sufferer, together with preoperative and postoperative care. The booklet is illustrated all through with sensible algorithms, helpful tables and examples of neuroimaging. Written via major neuroanesthesiologists, neurologists, neuroradiologists and neurosurgeons from the college of Michigan scientific university and the Cleveland health facility, those transparent, concise situations are a great option to organize for particular surgical situations or to help research for either written and oral board examinations.
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Additional resources for Case Studies in Neuroanesthesia and Neurocritical Care
Remifentanil has become a very popular option due to its ultra-short half life and ease of titration; however, longer-acting opioids must be given after the infusion is stopped. Sufentanil is more potent than fentanyl and has a duration of action between that of remifentanil and fentanyl. Dexmedetomidine is an alpha-2-adrenoceptor agonist that is frequently used in neurosurgical anesthesia . Whereas dexmedetomidine will not suffice as a sole anesthetic, it provides sedation, anxiolysis, 17 I.
Klein et al. Anaesthesia in haemodynamically compromised emergency patients: does ketamine represent the best choice of induction agent? Anaesthesia 2009; 64: 532–9. Part I Case 4 Craniotomy. Supratentorial craniotomy Postoperative seizure Allen Keebler Postoperative seizures are a relatively common occurrence after surgery. They are very common in the intensive care unit, even in patients without a primary neurologic diagnosis. The incidence has been reported to be as high as 12% in this setting.
Depending on the dose and route of administration of the antiepileptic given, therapeutic levels may not have been achieved by the time of operation. This may simply be cortical irritation from the surgery because of nontherapeutic levels of the antiepileptic. A thor- 16 ough medication review and discussion with the surgical team will help you decide on the prophylaxis to be given. In this case, the cause was found to be a subdural hematoma at the surgical site and the patient returned to the operating room for decompression.