Simulation to become a better neurosurgeon. An international prospective controlled trial: The Passion study.

Introduction: Surgical training traditionally adheres to the apprenticeship paradigm, potentially exposing trainees to an increased risk of complications stemming from their limited experience. To mitigate this risk, augmented and virtual reality have been considered, though their effectiveness is difficult to assess.

Research Question: The PASSION study seeks to investigate the improvement of manual dexterity following intensive training with neurosurgical simulators and to discern how surgeons' psychometric characteristics may influence their learning process and surgical performance.

A virtual reality home-based training for the management of stress and anxiety among healthcare workers during the COVID-19 pandemic: study protocol for a randomized controlled trial.

Background: Healthcare workers represent one of the most affected categories by the adverse effects of the COVID-19 pandemic on mental health. Excessive stress and anxiety are critical factors that could compromise work performance. Besides, high levels of stress and anxiety may have long-term physical and psychological consequences.

Effects of direct laryngoscopy versus Glidescope videolaryngoscopy on subjective and objective measures of cognitive workload: an in-vivo randomized trial.

Background: Laryngoscopy and tracheal intubation are associated with high operators' workload, which potentially causes lower performance and risk of errors. Measuring anesthesiologists' mental workload during instrumental procedures allows to test the usability of the devices and, by managing operators' workload, improve clinical decision making. The aim of this study was to investigate the differences in subjective and objective cognitive workload between videolaryngoscopy with hyperangulated blade (Glidescope) vs.

Analyzing the Loss and the Recovery of Consciousness: Functional Connectivity Patterns and Changes in Heart Rate Variability During Propofol-Induced Anesthesia.

The analysis of the central and the autonomic nervous systems (CNS, ANS) activities during general anesthesia (GA) provides fundamental information for the study of neural processes that support alterations of the consciousness level. In the present pilot study, we analyzed EEG signals and the heart rate (HR) variability (HRV) in a sample of 11 patients undergoing spinal surgery to investigate their CNS and ANS activities during GA obtained with propofol administration. Data were analyzed during different stages of GA: baseline, the first period of anesthetic induction, the period before the loss of consciousness, the first period after propofol discontinuation, and the period before the recovery of consciousness (ROC).

Propofol and sevoflurane affect intra-operative memory formation of words differently: A prospective cohort study.

Background: Memory priming seems possible even during apparently adequate anaesthesia. However, the effects of different anaesthetics and type of stimuli, by virtue of their specific neural underpinnings, have not been considered.

Objective: To determine if intra-operative implicit memory is affected by the type of anaesthesia (propofol or sevoflurane) or by the type of stimuli (abstract or concrete words).

Informed consent through 3D virtual reality: a randomized clinical trial.

Background: The informed consent is a defining moment that should allow patients to understand their condition, what procedure they are undergoing, and what consequences may follow. This process should foster trust and promote confidence, without increasing patients' anxiety. New immersive 3D imaging technologies may serve as a tool to facilitate this endeavor.

Filling the gap between the OR and virtual simulation: a European study on a basic neurosurgical procedure.

Background: Currently available simulators are supposed to allow young neurosurgeons to hone their technical skills in a safe environment, without causing any unnecessary harm to their patients caused by their inexperience. For this training method to be largely accepted in neurosurgery, it is necessary to prove simulation efficacy by means of large-scale clinical validation studies.

Methods: We correlated and analysed the performance at a simulator and the actual operative skills of different neurosurgeons (construct validity).

Motor Evoked Potentials and Bispectral Index-Guided Anaesthesia in Image-Guided Mini-Invasive Neurosurgery of Supratentorial Tumors Nearby the Cortico-Spinal Tract.

Aim: To describe and evaluate the anaesthesiological regimen used in neurophysiologically monitored image-guided mini-invasive neurosurgery.

Material And Methods: Twenty-four patients underwent elective surgery under general anaesthesia that was administered through Target Controlled Infusion (TCI) for effect-site concentration (Ce) of Propofol and Remifentanil, targeting the Bispectral Index (BIS) in the 40-60 intervals. The stimulating intensity of transcranial motor evoked potentials (tMEP), BIS, Propofol and Remifentanil Ce were collected at MEPs threshold (T) definition (respectively BIS@T, CeProp@T and CeRemi@T).

The role of anesthesia in the prevention of postoperative delirium: a systematic review.

Introduction: Postoperative delirium (POD) is defined as an acute neurologic insult characterized by changes in consciousness and cognition, altered perception and a fluctuating course. It leads to poor outcome and increased health care system costs. Considering its high incidence, up to 60%, and the lack of a first-choice treatment, prevention has become a priority.

Does the Maslach Burnout Inventory correlate with cognitive performance in anesthesia practitioners? A pilot study.

Background: Chronic stress is a common condition among health-care operators, anesthetists in particular. It is known to cause cognitive weakening and pathological outcomes, as the Burnout syndrome. Nevertheless, the impact of clinicians' health on their performance has received limited attention thus far.

Application of an aviation model of incident reporting and investigation to the neurosurgical scenario: method and preliminary data.

Object: Incident reporting systems are universally recognized as important tools for quality improvement in all complex adaptive systems, including the operating room. Nevertheless, introducing a safety culture among neurosurgeons is a slow process, and few studies are available in the literature regarding the implementation of an incident reporting system within a neurosurgical department. The authors describe the institution of an aviation model of incident reporting and investigation in neurosurgery, focusing on the method they have used and presenting some preliminary results.