Ability of the integrated pulmonary index to predict impending respiratory events in the early postoperative period.

Background: In the early postoperative period, respiratory compromise is a significant problem. Standard-of-care monitoring includes respiratory rate (RR) and pulse oximetry, which are helpful; however, low SpO is often a late sign during decompensation. The FDA-approved Capnostream-20p monitor records four variables (SpO, RR, End-tidal CO, heart rate), which are combined by fuzzy logic into a single, unit-less value (range 1-10) called the integrated pulmonary index (IPI).

Enhanced recovery after surgery (ERAS) program for lumbar spine fusion.

Background: There is a paucity of literature regarding the implementation of enhanced recovery after surgery (ERAS) protocols for open lumbar spine fusions. We implemented an ERAS program for 1-2-level lumbar spine fusion surgery and identified areas that might benefit from perioperative interventions to improve patient satisfaction and outcomes.

Methods: This institutionally approved quality improvement (QI) ERAS program for lumbar spine fusion was designed for all neurosurgical patients 18 years and older scheduled for 1 or 2 level primary lumbar fusions.

Anesthesia with Dexmedetomidine and Low-dose Isoflurane Increases Solute Transport via the Glymphatic Pathway in Rat Brain When Compared with High-dose Isoflurane.

Background: The glymphatic pathway transports cerebrospinal fluid through the brain, thereby facilitating waste removal. A unique aspect of this pathway is that its function depends on the state of consciousness of the brain and is associated with norepinephrine activity. A current view is that all anesthetics will increase glymphatic transport by inducing unconsciousness.

Deliberate hypotensive anesthesia with the rapidly acting, vascular-selective, L-type calcium channel antagonist-clevidipine: a case report.

Deliberate hypotension is an important technique for use in select anesthetics for procedures such as orthognathic surgery, specifically LeFort I maxillary osteotomy. We present a case report of an anesthetic involving deliberate hypotension for a 17-year-old female patient who presented for a LeFort I osteotomy, bilateral sagittal split of the mandible, and a genioplasty in order to correct a skeletal class III malocclusion. After reaching a steady-state general anesthetic, deliberate hypotension was induced solely with a bolus and subsequent continuous infusion of the ultrashort acting calcium channel blocker, clevidipine.