Awake craniotomy using a high-flow nasal cannula with oxygen reserve index monitoring - A report of two cases.

Background: Awake craniotomy is a well-tolerated procedure for the resection of brain tumors residing within or close to the eloquent cortical areas. Monitored anesthesia care (MAC) is a dominant anesthetic approach for awake craniotomy; however, it is associated with inherent challenges such as desaturation and hypercapnia, which may lead to various complications. The prevention of respiratory insufficiency is important for successful awake craniotomy.

Pre-administration of remifentanil in target-controlled propofol and remifentanil anesthesia prolongs anesthesia induction in neurosurgical patients: A double-blind randomized controlled trial.

Background: Pre- and co-administration of remifentanil in target-controlled propofol and remifentanil anesthesia are the most common methods in clinical practice. However, anesthesia induction time by timing remifentanil administration was not identified. Therefore, we investigated the induction time of anesthesia based on type of remifentanil administration in target-controlled anesthesia.

Effects of lowering inspiratory oxygen fraction during microvascular decompression on postoperative gas exchange: A pre-post study.

Background: Despite many previous studies, the optimal oxygen fraction during general anesthesia remains controversial. This study aimed to evaluate the effects of lowering intraoperative fraction of inspired oxygen on postoperative gas exchange in patients undergoing microvascular decompression (MVD).

Methods: We conducted a pre-post study to compare postoperative gas exchange with different intraoperative oxygen fractions.

Effects of partial neuromuscular blockade on lateral spread response monitoring during microvascular decompression surgery.

Objective: We evaluated the effect of partial neuromuscular blockade (NMB) and no NMB on successful intraoperative monitoring of the lateral spread response (LSR) during microvascular decompression (MVD) surgery.

Methods: Patients were randomly allocated into one of three groups: the TOF group, the NMB was targeted to maintain two counts of train-of-four (TOF); the T1 group, maintain the T1/Tc (T1: amplitude of first twitch, Tc: amplitude of baseline twitch) ratio at 50%; and the N group, no relaxants after tracheal intubation. Successful LSR monitoring was defined as effective baseline establishment and maintenance of the LSR until dural opening.

Postoperative obstructing laryngeal edema in patients with diffuse idiopathic skeletal hyperostosis of cervical spine -A report of two cases-.

Two cases were reported in which severe postoperative laryngeal edema were developed after the operation of diffuse idiopathic skeletal hyperostosis (DISH) of cervical spine. In the first case, sudden airway obstruction was developed in the general ward 6 hour after uneventful decompression surgery for osteophyte. In the second patient, an elective preoperative tracheostomy was performed before surgery but the tube could not be removed for 2 months because of laryngeal edema and decreased vocal cord mobility.

The comparison of complications on the endovascular and surgical treatment in elderly cerebral aneurysm patients.

Background: The aim of this study was to compare intraoperative and postoperative complications and clinical outcome of endovascular coiling (EVT) with neurosurgical clipping (NST) under general anesthesia in the cerebral aneurysm patients older than 60 years.

Methods: We retrospectively reviewed the charts, operative reports of patients who underwent EVT or NST at our hospital between January 2006 and August 2008. A total of 181 patients (EVT = 78, NST = 103) were included in this study.

Effect of preoperative skull block on pediatric moyamoya disease.

Object: Stable hemodynamics, normocapnia, and adequate pain relief are considered important factors in the reduction of neurological complications in pediatric patients undergoing encephaloduroarteriomyosynangiosis (EDAMS) operations for the treatment of moyamoya disease. A preoperative skull block may reduce hemodynamic fluctuations and hypo- or hyperventilation due to emergence delirium or oversedation and provide adequate pain relief, thereby reducing postoperative morbidity.

Methods: Pediatric patients (age 3-13 years) undergoing EDAMS surgery for moyamoya disease were randomly divided into a nerve block (NB) group (18 cases) or control group (21 cases).

Multistage ethanol sclerotherapy of soft-tissue arteriovenous malformations: effect on pulmonary arterial pressure.

Purpose: To retrospectively investigate how repeat injections of absolute ethanol in therapeutic doses, required for multisession sclerotherapy of large high-flow soft-tissue arteriovenous malformations (AVMs) in patients with normal cardiopulmonary function, affect pulmonary arterial pressure (PAP).

Materials And Methods: Study received approval and waiver of informed consent by institutional review board and was conducted in 16 male and 16 female patients with AVMs who underwent repeat sclerotherapy (142 sessions total) with absolute ethanol from July 1997 to December 2003. PAPs were monitored during first session in all patients.