AnesthesiaNeurosurgeryNeurosurgical proceduresResectionOutcomesAnalgesicThiopentalFentanylSedationHigh-grade gliomasSurgicalProtocolsSubarachnoid hemorrhagePost-operativeSurgeryOpioidsStrategiesTumorUnderwentRecoveryConsiderationIntraoperativeInducePerioperativePainClinicalPreoperativeSurvivalSuccessfulRiskTimeCareSelectionTrialStudyTechniquesEvaluated due
Anesthesia6
- Describe the considerations to achieve induction of anesthesia for craniotomy as safely as possible. (snacc.org)
- More rigorous patient education, recovery room assessment for non-ICU admission, earlier mobilization and post-discharge communication, layered upon a foundation of minimally invasive surgery, TIVA anesthesia and early post-operative imaging are possible contributors to these favorable trends. (plos.org)
- In combination with propofol, remifentanil is used for anesthesia of patients undergoing electroconvulsive therapy. (wikipedia.org)
- Thiopental is often used as an induction agent to rapidly induce anesthesia in patients undergoing neurosurgical procedure s. (neurosurgery.directory)
- Chemically, propofol is not related to barbiturates and has largely replaced sodium thiopental (Pentothal) for induction of anesthesia because recovery from propofol is more rapid and "clear" when compared with thiopental. (neurosurgery.directory)
- After induction of anesthesia, the patients received dexmedetomidine or midazolam based on the group they allocated to. (ac.ir)
Neurosurgery2
- The goal of this review is to create an alembic for the design of a standardized pain management protocol for craniotomy in the context of the development of an ERAS protocol for neurosurgery. (surgicalneurologyint.com)
- Background: This study aimed to compare the hemodynamic effects of dexmedetomidine and midazolam in neurosurgery candidates who underwent skull-pin head-holder insertion.Methods: In this randomized clinical trial study, 68 patients candidate for neurosurgery were divided into two groups receiving dexmedetomidine or midazolam. (ac.ir)
Neurosurgical procedures2
- With limited ICU beds and the concern of viral transmission between patients and caregivers, many hospitals stopped non-emergent neurosurgical procedures for several weeks or months early in the pandemic then gradually resumed as COVID-dedicated wards were established [ 7 , 8 ]. (plos.org)
- Awake craniotomy (AC) is required for neurosurgical procedures when the patient is needed to be awake and cooperative during certain stage ofthe procedure. (wfsahq.org)
Resection10
- Awake craniotomy is commonly indicated for resection of tumours near or within the eloquent areas of the brain to maximize tumour resection while preserving the vital neurological functions. (wfsahq.org)
- Gross total resection (GTR) was achieved in 66.7 % of the patients, mean 90.4±3.7 % without neurological deficits. (neurorgs.net)
- Resection in four patients was stopped by the occurrence of severe warning criteria despite the presence of fluorescence. (neurorgs.net)
- IONM can be helpful during surgery to maximize the tumor resection, meanwhile help to avoid neurological deficits and, therefore, to improve the quality of life of these patients. (neurorgs.net)
- Tumor Resection Rate: Patients with standard-risk medulloblastoma typically have a high rate of tumor resection. (neurosurgery.directory)
- In contrast, high-risk patients may face a more challenging treatment course and potentially a poorer prognosis due to the presence of metastasis and the difficulty in achieving complete tumor resection. (neurosurgery.directory)
- 20% of patients underwent near-total resection of the lesions. (nexstim.com)
- In only one patient was no surgical resection possible after both preoperative and intraoperative mapping. (nexstim.com)
- The independently acquired anatomical (anatomical MRI) and functional (nTMS and tractography) tests in patients with CST lesions provide a useful guide for resection. (nexstim.com)
- Preoperative Navigated Transcranial Magnetic Stimulation Improves Gross Total Resection Rates in Patients with Motor-Eloquent High-Grade Gliomas: A Matched Cohort Study. (nexstim.com)
Outcomes4
- What tactics should be employed during temporary clipping to improve patient outcomes? (snacc.org)
- Development of standardized pain management and enhanced recovery after surgery (ERAS) protocols are necessary and crucial to optimize outcomes and patient satisfaction and reduce health care costs. (surgicalneurologyint.com)
- Pain after craniotomy is a common occurrence[ 96 ] and associated with poor outcomes. (surgicalneurologyint.com)
- Our findings contribute to enhanced survival outcomes for patients with medulloblastoma. (neurosurgery.directory)
Analgesic2
- The use of dexmedetomidine for sedation during awake craniotomy is gaining popularity due to its analgesic and sedative properties with minimal respiratory depression. (wfsahq.org)
- Propofol is not considered an analgesic, so opioids such as fentanyl may be combined with propofol to alleviate pain. (neurosurgery.directory)
Thiopental2
- Thiopental induces a state of sedation, amnesia, and unconsciousness, which is important for ensuring that patients do not experience pain or awareness during surgery. (neurosurgery.directory)
- Thiopental and decompressive craniectomy are important integrated last-tier treatment options in aneurysmal subarachnoid hemorrhage , but careful patient selection is needed due to the risk of saving many patients a state of suffering 6) . (neurosurgery.directory)
Fentanyl1
- The most common side effects reported by patients receiving this medication are a sense of extreme "dizziness" (often short lived, a common side effect of other fast-acting synthetic phenylpiperidine narcotics such as fentanyl and alfentanil) and intense itching (pruritus), often around the face. (wikipedia.org)
Sedation1
- The clinically useful infusion rates are 0.025-0.1 (µg/kg)/min for sedation (rates adjusted to age of patient, severity of their illness and invasiveness of surgical procedure). (wikipedia.org)
High-grade gliomas1
- These aspects are particularly relevant in patients suffering from high-grade gliomas, where survival is directly related to the degree of tumor removal [23, 24]. (neurorgs.net)
Surgical4
- The COVID-19 pandemic forced a reconsideration of surgical patient management in the setting of scarce resources and risk of viral transmission. (plos.org)
- Craniotomy is a relatively common surgical procedure with a high incidence of postoperative pain. (surgicalneurologyint.com)
- Lesions within the primary motor cortex (M1) and the corticospinal tract (CST) represent a significant surgical challenge with a delicate functional trade-off that should be integrated in the overall patient-centered treatment plan. (nexstim.com)
- Navigated Transcranial Magnetic Stimulation Motor Mapping Usefulness in the Surgical Management of Patients Affected by Brain Tumors in Eloquent Areas: A Systematic Review and Meta-Analysis. (nexstim.com)
Protocols1
- This work is based on pertinent literature published from 1996, the date of a pivotal pilot study on craniotomy pain,[ 11 ] until 2017, by searching Pubmed, Cochrane Central Register, and Google Scholar using a combination of medical subject headings (MeSH) terms and free-text words to identify manuscripts related to postcraniotomy pain and ERAS protocols. (surgicalneurologyint.com)
Subarachnoid hemorrhage1
- When evaluating a patient with subarachnoid hemorrhage, what are the clinical findings associated with a poor outcome? (snacc.org)
Post-operative3
- What are the risks to the patient in the immediate post-operative period? (snacc.org)
- The patient is in the neurointesive care unit (NICU) on post-operative day 4 extubated and seemingly stable. (snacc.org)
- Delayed cerebral ischemia can manifest after a successful operation for securing the aneurysm and patients at risk require monitoring for this complication in the post-operative period. (snacc.org)
Surgery15
- How does one decide between open craniotomy for aneurysm surgery and endovascular therapy? (snacc.org)
- Herein we assess the impact of implementing a protocol of more rigorous patient education, recovery room assessment for non-ICU admission, earlier mobilization and post-discharge communication for patients undergoing brain tumor surgery. (plos.org)
- It is given to patients during surgery to relieve pain and as an adjunct to an anaesthetic. (wikipedia.org)
- It has been used effectively during craniotomies, spinal surgery, cardiac surgery, and gastric bypass surgery. (wikipedia.org)
- This tutorial discusses the rationale for using AC for brain surgery, perioperative management of the patients, theatre preparation, the different anaesthetic techniques, and the adverse events during AC. (wfsahq.org)
- Information leaflets and videos help relieve patient anxiety surrounding the procedure and give them an idea about what to expect on the day of surgery. (wfsahq.org)
- The neurophysiologist and speech/language therapist usually meet the patient before the surgery to provide training on the tasks they have to perform intraoperatively. (wfsahq.org)
- We assessed the role of IONM in FGR surgery in patients harboring tumors in or near eloquent areas. (neurorgs.net)
- Notably, a significant percentage of patients exhibited clinical improvement after the surgery. (neurorgs.net)
- One week after surgery, only one patient worsened, and seven patients improved. (neurorgs.net)
- At 3 months, 27.8 % of the patients improved, and the other patients maintained a similar status to their pre-surgery condition. (neurorgs.net)
- Warning common criteria (amplitude reduction and/or latency increase) appeared in 68.2 and 50.0 % of patients during cortical or semioval surgery, respectively, with neither a false-negative nor a false-positive clinical outcome. (neurorgs.net)
- 100 ] Preoperative interventions aim at optimizing the patient for surgery, including patient education, risk assessment, and medication. (surgicalneurologyint.com)
- This study evaluates whether ketamine, given as part of an anesthetic, improves depression symptoms in depressed patients undergoing non-cardiac surgery. (stanford.edu)
- Patients who underwent surgery for a motor-eloquent supratentorial glioma or metastasis guided by preoperative nTMS were retrospectively reviewed. (nexstim.com)
Opioids1
- Opioids remain the mainstay for pain relief, but patient-controlled analgesia, NSAIDs, standardization of pain management, bio/behavioral interventions, modification of head dressings as well as patient-centric management are useful opportunities that potentially improve patient care. (surgicalneurologyint.com)
Strategies2
- Strategies to ameliorate craniotomy pain demand interventions during all phases of patient care: preoperative, intraoperative, and postoperative interventions. (surgicalneurologyint.com)
- This molecular-based classification holds promise in guiding the development of optimal treatment strategies for patients with medulloblastoma 1) . (neurosurgery.directory)
Tumor3
- All patients undergoing craniotomy or endoscopic endonasal removal of a brain, skull base or pituitary tumor were included during two non-overlapping periods: March 2019-January 2020 (pre-pandemic epoch) versus March 2020-January 2021 (pandemic epoch with streamlined care protocol implemented). (plos.org)
- Metastasis: Standard-risk patients usually do not have evidence of metastasis, which means that the cancer cells have not spread from the primary tumor site in the cerebellum to other parts of the central nervous system (CNS) or outside the CNS. (neurosurgery.directory)
- Patients with standard-risk medulloblastoma may have a more favorable prognosis because of the higher likelihood of complete tumor removal and the absence of metastasis. (neurosurgery.directory)
Underwent1
- 3 Improved patient satisfaction and postoperative pain were also observed in patients who underwent AC. (wfsahq.org)
Recovery1
- 3 It may allow for enhanced recovery after craniotomy with same-day discharge. (wfsahq.org)
Consideration1
- There are interactions between other organ systems (for example the heart and lungs) that may complicate the care of a ruptured cerebral aneurysm patient and need consideration. (snacc.org)
Intraoperative1
- Patients with lesions within the M1 and CST with preoperative cortical and subcortical mapping (navigated transcranial magnetic stimulation [nTMS] and tractography), intraoperative mapping, and intraoperative provisional histologic information (smear with and without 5-aminolevulinic acid [5-ALA]) were included. (nexstim.com)
Induce1
- Methohexital differs from other barbiturates in regard to epileptiform activity in that it may induce seizures in patients who have epilepsy and thus increase CMRo 2 and CBF. (neuro-anesthesia.org)
Perioperative1
- Pain management should begin in the perioperative period with risk assessment, patient education, and premedication. (surgicalneurologyint.com)
Pain1
- A review of craniotomy pain management detailing all the considerations for each phase of care is currently unavailable. (surgicalneurologyint.com)
Clinical1
- In addition to treating patients, Dr. Heifets also directs both clinical research and basic neuroscience. (stanford.edu)
Preoperative2
- The preoperative assessment is the ideal time to establish a good rapport with the patient, to explain the procedure in detail, and to answer patient questions. (wfsahq.org)
- Most of the patients (60%) had a preoperative motor deficit. (nexstim.com)
Survival1
- In multivariable Cox-regression analysis, prolonged survival in WHO III/IV glioma was significantly associated with achievement of GTR and younger patient age but not nTMS mapping. (nexstim.com)
Successful1
- Efficient scalp anaesthesia is the cornerstone for a successful awake craniotomy procedure. (wfsahq.org)
Risk2
- Metastasis: High-risk patients typically have evidence of metastasis. (neurosurgery.directory)
- It's important to note that treatment approaches for these two risk groups may differ, with high-risk patients typically receiving more intensive therapies to address the increased complexity and aggressiveness of their disease. (neurosurgery.directory)
Time1
- What is the time frame that leads to the best patient outcome for securing intracranial aneurysms? (snacc.org)
Care1
- As the COVID-19 pandemic spread into the U.S. and global healthcare system in February and March of 2020, hospitals rapidly adjusted to care for the influx of infected patients [ 1 - 3 ]. (plos.org)
Selection1
- The success of AC depends on appropriate patient selection. (wfsahq.org)
Trial1
- Stanford is currently not accepting patients for this trial. (stanford.edu)
Study1
- 1 patient with precentral cavernoma) were included in the study. (nexstim.com)
Techniques1
- Different combinations of neurophysiological techniques were used depending on each patient. (neurorgs.net)
Evaluated due1
- Airway: C-spine collar is in place, Mallampati score is unable to be evaluated due to patient inability to participate with the exam. (snacc.org)