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Intraoperative Anesthetic Care During Emergent/Urgent Craniotomy or Craniectomy for Intracranial Hypertension or Herniation: A Systematic Review.
J Neurosurg Anesthesiol
November 2024
Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA.
This systematic review aimed to identify and describe best practice for the intraoperative anesthetic management of patients undergoing emergent/urgent decompressive craniotomy or craniectomy for any indication. The PubMed, Scopus, EMBASE, and Cochrane databases were searched for articles related to urgent/emergent craniotomy/craniectomy for intracranial hypertension or brain herniation. Only articles focusing on intraoperative anesthetic management were included; those investigating surgical or intensive care unit management were excluded.
View Article and Find Full Text PDFThe effect of the type of anaesthesia on long-term outcomes after cancer resection surgery: a narrative review.
Anaesthesia
February 2025
EuroPeriscope, ESA-IC Onco-Anaesthesiology Research Group ESA_IC_RG_EP, Brussels, Belgium.
Background: The peri-operative period may create a biological environment conducive to cancer cell survival and dissemination. Microscopic residual tumours (micrometastases) can be dislodged even with excellent surgical technique. At the same time, the stress response from surgery can temporarily impair immune function and activate inflammatory processes, increasing the risk of tumour proliferation.
View Article and Find Full Text PDFInhaled Anesthetics: Beyond the Operating Room.
J Clin Med
December 2024
Department of Anesthesiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
The development of inhaled anesthetics (IAs) has a rich history dating back many centuries. In modern times they have played a pivotal role in anesthesia and critical care by allowing deep sedation during periods of critical illness and surgery. In addition to their sedating effects, they have many systemic effects allowing for therapy beyond surgical anesthesia.
View Article and Find Full Text PDFContributions of Medical Greenhouse Gases to Climate Change and Their Possible Alternatives.
Int J Environ Res Public Health
November 2024
Institute of Marine and Environmental Technology, Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Considerable attention has recently been given to the contribution of the greenhouse gas (GHG) emissions of the healthcare sector to climate change. GHGs used in medical practice are regularly released into the atmosphere and contribute to elevations in global temperatures that produce detrimental effects on the environment and human health. Consequently, a comprehensive assessment of their global warming potential over 100 years (GWP) characteristics, and clinical uses, many of which have evaded scrutiny from policy makers due to their medical necessity, is needed.
View Article and Find Full Text PDFBackground: Previously, a depth of anesthesia bispectral index (BIS™) <45 was considered lowand found to have no clinical benefit. A BIS <35 was considered very low and was not only without evident clinical benefit but also associated with a greater risk of postoperative delirium. We considered the association between BIS and the anesthetic dose of inhalational agents, quantified using the minimum alveolar concentration (MAC) fraction, which was the patient's end-tidal inhalational agent concentration divided by the agent's altitude- and age-adjusted minimum alveolar percentage concentration.
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