With the advent of modern techniques, drugs, and monitoring, general anesthesia has come to be considered an unlikely cause of harm, particularly for healthy patients. While this is largely true, newly emerging clinic...With the advent of modern techniques, drugs, and monitoring, general anesthesia has come to be considered an unlikely cause of harm, particularly for healthy patients. While this is largely true, newly emerging clinical and laboratory studies have sug- gested that exposure to anesthetic agents during early childhood may have long-lasting adverse effects on cognitive function. This concern has been the focus of intense study in the field of anesthesia research. A recent high-profile review by Rappaport et al. （2015） concluded that while many questions remain un- answered, there is strong evidence from laboratory studies that commonly used anesthetics interfere with brain development and that clinical studies suggest a correlation between early childhood exposure to these agents and subsequent effects on learning and cognition. The issue is of sufficient public health importance that a public-private partnership known as Smar- Tots （Strategies for Mitigating Anesthesia-Related Neurotoxicity in Tots） was developed by the FDA to study pediatric anesthetic neurotoxicity. The mechanism of injury underlying this phe- nomenon has yet to be fully elucidated, and there is evidence to suggest that anesthetics may have direct cytotoxic effects on neurons leading to cell death or suppressed neurogenesis （Strat- mann et al., 2010） and that they may interfere with key pro- cesses in neuronal growth and development that underlie brain circuit development （Wagner et al., 2014）.展开更多
Objective To evaluate the feasibility and safety of the self developed sound outside the ventilation device-esophageal nasopharynx catheter in brain functional areas surgery applications. Methods 13 patients involved ...Objective To evaluate the feasibility and safety of the self developed sound outside the ventilation device-esophageal nasopharynx catheter in brain functional areas surgery applications. Methods 13 patients involved functional areas of brain surgery were chosed. After induction of general anesthesia,the catheters were placed in the esophagus,then connected to anesthesia machines to an external展开更多
Penetrating traumatic brain injuries (TBI) are frequent neurosurgical emergencies, associated with a high mortality rate and we almost no previous report on a penetrating pickaxe TBI. Herein, we report and discuss the...Penetrating traumatic brain injuries (TBI) are frequent neurosurgical emergencies, associated with a high mortality rate and we almost no previous report on a penetrating pickaxe TBI. Herein, we report and discuss the anesthetic challenges encountered in the surgical extraction a pickaxe from a patient with TBI. We present the case of a 34-year-old man who with a penetrating pickaxe TBI at his left temporal region, signs of raised intracranial pressure and normal vital signs. Anesthetic management began within 3 hours of admission and consisted of general anesthesia and rapid sequence intubation. Surgical extraction of a 14 cm long wing of the pickaxe was achieved with good hemostatic control. His postoperative course was marked by complete blindness of the right eye till one year of follow-up. The authors highlight the need of a prompt multidisciplinary management with close perioperative monitoring of haemostatic control and signs of raised intracranial pressure as key factors for a favourable postoperative outcome.展开更多
文摘With the advent of modern techniques, drugs, and monitoring, general anesthesia has come to be considered an unlikely cause of harm, particularly for healthy patients. While this is largely true, newly emerging clinical and laboratory studies have sug- gested that exposure to anesthetic agents during early childhood may have long-lasting adverse effects on cognitive function. This concern has been the focus of intense study in the field of anesthesia research. A recent high-profile review by Rappaport et al. （2015） concluded that while many questions remain un- answered, there is strong evidence from laboratory studies that commonly used anesthetics interfere with brain development and that clinical studies suggest a correlation between early childhood exposure to these agents and subsequent effects on learning and cognition. The issue is of sufficient public health importance that a public-private partnership known as Smar- Tots （Strategies for Mitigating Anesthesia-Related Neurotoxicity in Tots） was developed by the FDA to study pediatric anesthetic neurotoxicity. The mechanism of injury underlying this phe- nomenon has yet to be fully elucidated, and there is evidence to suggest that anesthetics may have direct cytotoxic effects on neurons leading to cell death or suppressed neurogenesis （Strat- mann et al., 2010） and that they may interfere with key pro- cesses in neuronal growth and development that underlie brain circuit development （Wagner et al., 2014）.
文摘Objective To evaluate the feasibility and safety of the self developed sound outside the ventilation device-esophageal nasopharynx catheter in brain functional areas surgery applications. Methods 13 patients involved functional areas of brain surgery were chosed. After induction of general anesthesia,the catheters were placed in the esophagus,then connected to anesthesia machines to an external
文摘Penetrating traumatic brain injuries (TBI) are frequent neurosurgical emergencies, associated with a high mortality rate and we almost no previous report on a penetrating pickaxe TBI. Herein, we report and discuss the anesthetic challenges encountered in the surgical extraction a pickaxe from a patient with TBI. We present the case of a 34-year-old man who with a penetrating pickaxe TBI at his left temporal region, signs of raised intracranial pressure and normal vital signs. Anesthetic management began within 3 hours of admission and consisted of general anesthesia and rapid sequence intubation. Surgical extraction of a 14 cm long wing of the pickaxe was achieved with good hemostatic control. His postoperative course was marked by complete blindness of the right eye till one year of follow-up. The authors highlight the need of a prompt multidisciplinary management with close perioperative monitoring of haemostatic control and signs of raised intracranial pressure as key factors for a favourable postoperative outcome.
