Pedicle Screw Instrumentation of the Cervicothoracic Junction in the Sitting Position using CT-guided Navigation: Application and Technical Aspects.

Background:  We evaluate the feasibility and potential advantages of spinal CT navigation in the placement of pedicle screws at the cervicothoracic junction in the sitting position to counteract the anatomy-related limitations of 2D fluoroscopy.

Methods:  We retrospectively analyze the data from 15 patients who underwent CT-based navigation-guided placement of a total of 36 pedicle screws at the cervicothoracic junction in the sitting position.

Results:  CT-based spinal navigation is a useful method in increasing accuracy of pedicle screw instrumentation in the sitting position, successfully counteracting the anatomy-related limitations of 2D fluoroscopy at the cervicothoracic junction.

Small doses of epinephrine prolong the recovery from a rocuronium-induced neuromuscular block: a case report.

Background: During anaesthesia it is not uncommon to administer epinephrine in patients blocked by non-depolarizing muscle relaxants. However, there are few reports on possible interaction of epinephrine with neuromuscular transmission in humans.

Case Presentation: An otherwise healthy 74-yr-old man underwent transurethral resection of a benign prostatic hyperplasia under total intravenous anaesthesia.

Intraoperative continuous cerebral microcirculation measurement in patients with aneurysmal subarachnoid hemorrhage: preliminary data on the early administration of magnesium sulfate.

Background: In patients with subarachnoid hemorrhage (SAH), vasospasm remains one of the major complications. The application of intravenous magnesium sulfate (MgSO) has been under discussion to prevent cerebral ischemia. Our aim was to examine the impact of early MgSO administration on local cerebral microcirculation during microsurgical clipping of SAH-related aneurysms.

Intravenous theophylline is the most effective intervention to prolong EEG seizure duration in patients undergoing electroconvulsive therapy.

Background: Seizure duration in electroconvulsive therapy (ECT) is positively related with patients' outcome. This study sought to investigate the impact of anesthetic management on seizure duration, and the impact of selected drugs (theophylline, remifentanil, S-ketamine) on seizure duration.

Methods: Retrospective analysis of all patients undergoing ECT at our institution from January 2011 to April 2012 was performed based on electronic medical chart and review of existing quality improvement data.

Intraoperative Vascular Neuromonitoring in Patients with Subarachnoid Hemorrhage: A Pilot Study Using Combined Laser-Doppler Spectrophotometry.

Background: Intraoperative monitoring of cerebral microcirculation in patients with subarachnoid hemorrhage (SAH) may predict the postoperative neurologic outcome. In this pilot study, we examined the value of a novel noninvasive real-time measurement technique for detecting changes in local microcirculation.

Methods: We used the O2C (Oxygen to see) laser-Doppler spectrophotometry system in 14 patients with Hunt & Hess grade 2-5 SAH who underwent microsurgical cerebral aneurysm clipping.

Combined Laser-Doppler Flowmetry and Spectrophotometry: Feasibility Study of a Novel Device for Monitoring Local Cortical Microcirculation during Aneurysm Surgery.

 Monitoring of cortical cerebral perfusion is essential, especially in neurovascular surgery.  To test a novel noninvasive laser-Doppler flowmetry and spectrophotometry device for feasibility during elective cerebral aneurysm surgery.  In this prospective single-institution nonrandomized trial, we studied local cerebral microcirculation using the noninvasive laser-Doppler spectrophotometer "Oxygen-to-see" (O2C) in 20 consecutive patients (15 female, 5 male; median age: 60.

Anatomical location of the vocal cords in relation to cervical vertebrae: A new predictor of difficult laryngoscopy?

Background: Several anatomical factors, such as prognathism, sex, short thyromental distance and others are known to make direct laryngoscopy difficult.

Objective: We investigated the hypothesis that the anatomical position of the vocal cords in relation to the cervical vertebrae correlates with difficult laryngoscopy. Existing MRI was used to identify the position of the vocal cords relative to the cervical spine in patients with and without difficult laryngoscopy.

Improved Postoperative Facial Nerve and Hearing Function in Retrosigmoid Vestibular Schwannoma Surgery Significantly Associated with Semisitting Position.

Objective: The pros and cons of semisitting positioning (SSP) versus lateral, horizontal positioning (LP) during retrosigmoid vestibular schwannoma (VS) surgery, especially concerning postoperative cranial nerve and brain stem preservation, are under continuous discussion.

Methods: In a single-center retrospective cohort study, 30 VSs operated on in SSP compared with 30 operated on in LP with comparable demography were analyzed. During SSP surgery, transesophageal echocardiographic monitoring for venous air embolism was used continuously.

Catheter-based distal sciatic nerve block in patients with Charcot-Marie-Tooth disease.

Background: The use of peripheral nerve blocks in patients with Charcot-Marie-Tooth (CMT) disease is scarcely reported; however, when performed it has proven to be effective for postoperative pain control.

Methods: A distal catheter-based sciatic nerve block for postoperative pain control was offered to 27 consecutive CMT patients scheduled for elective foot surgery. 18 of the 27 CMT patients consented to the offered sciatic nerve block.

The sitting position in neurosurgery: indications, complications and results. a single institution experience of 600 cases.

Background: The benefit of the sitting position for surgery of the posterior fossa and cervical spine is still a matter of controversy. In our study we analyzed the outcome after sitting position surgery at our institution. We compared the incidence of venous air embolism (VAE) as recognized with different monitoring techniques and the severity of complications.

Postictal agitation after electroconvulsive therapy: incidence, severity, and propofol as a treatment option.

Objectives: Postictal agitation (PIA) after electroconvulsive therapy (ECT) is a major medical problem. This observational study investigated the incidence and severity of PIA and evaluated propofol as a treatment option in a patient population.

Methods: The study included 14 patients that underwent a series of ECTs performed either with or without an approximately 0.

Anaesthetic management in patients with Duchenne muscular dystrophy undergoing orthopaedic surgery: a review of 232 cases.

Context: Patients with Duchenne muscular dystrophy are at increased risk of some anaesthesia-related hazards such as rhabdomyolysis, fever and hyperkalaemia.

Objectives: To evaluate the management of anaesthesia in patients with Duchenne muscular dystrophy, including preoperative evaluation, intraoperative performance, critical events and postoperative care.

Design: We performed a retrospective case review study of anaesthesia in patients with Duchenne muscular dystrophy covering the period between April 2000 and December 2008.

Transient increase of plasma concentrations of amyloid β peptides after electroconvulsive therapy.

Background: Electroconvulsive therapy (ECT) is applied to effectively treat depressive episodes, and it can be considered an ideal model of generalized seizures induced and performed under precisely controllable conditions.

Objective: We hypothesize that ECT causes a transiently increased blood-brain barrier permeability.

Methods: We measured plasma concentrations of amyloid β (Aβ) peptides: 1-42, 1-40, x-42, and x-40 before ECT, within 30 minutes after 2, and 24 hours after ECT treatment in 33-36 sessions of n=13 different patients.

Increased spike frequency during general anesthesia with etomidate for magnetoencephalography in patients with focal epilepsies.

Objective: Magnetoencephalography (MEG) is used for focus localization in presurgical evaluation of patients with focal epilepsies. In this proof-of-concept study, general anesthesia with etomidate was used to improve effectiveness of MEG-recordings.

Methods: MEG-recordings of six patients with focal epilepsy were performed before and after application of etomidate.

Influence of disease progression on the neuromuscular blocking effect of mivacurium in children and adolescents with Duchenne muscular dystrophy.

Background: Studies with nondepolarizing neuromuscular blocking agents showed a delayed onset and prolonged recovery in patients with Duchenne muscular dystrophy. The objective of this study was to investigate if these alterations depend on disease progression.

Methods: The authors studied 11 children (6-9 yr) with moderate Duchenne muscular dystrophy, 11 adolescents (12-16 yr) with advanced Duchenne muscular dystrophy, and 2 age-matched control groups of 8 patients each (5-9 and 10-17 yr).

Pharmacodynamic modelling of rocuronium in adolescents with Duchenne muscular dystrophy.

Background And Objective: Studies with rocuronium showed a delayed onset and prolonged recovery in patients with Duchenne muscular dystrophy (DMD). The objective of this study was to identify the pharmacokinetic and/or pharmacodynamic origin of these alterations.

Methods: Twenty-five male patients (15 with DMD, 10 controls, aged 10-18 years) were studied.

Reversal of rocuronium-induced neuromuscular blockade by pyridostigmine in patients with Duchenne muscular dystrophy.

Background: The aim of this study was to investigate the effect and safety of pyridostigmine for the reversal of a neuromuscular block (NMB) in patients with Duchenne muscular dystrophy (DMD). In patients with DMD recovery from a rocuronium-induced NMB is markedly delayed.

Methods: Fourteen DMD patients (aged between 11 and 19 years) scheduled for elective scoliosis repair were studied.

Mivacurium-induced neuromuscular block in adult patients suffering from Charcot-Marie-Tooth disease.

Purpose: The response to non-depolarizing neuromuscular blocking drugs is variable in patients with Charcot-Marie-Tooth (CMT) disease. We speculated that CMT involvement of the monitored muscle may be partially responsible for this inconsistency. We therefore investigated the response to a standard dose of mivacurium simultaneously assessed at adductor pollicis (AP) and orbicularis oculi (OO) muscles in five patients with CMT.

Rocuronium 0.3 mg x kg-1 (ED95) induces a normal peak effect but an altered time course of neuromuscular block in patients with Duchenne's muscular dystrophy.

Background: In patients with Duchenne's muscular dystrophy (DMD) recovery from neuromuscular block is delayed. It has been assumed that this is because of a higher potency of muscle relaxants in this patient cohort. We determined the peak effect, and the time course of action of rocuronium 0.