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Advances in Neuroscience in Anesthesia and Critical Care, An Issue of Anesthesiology Clinics, E-Book

Advances in Neuroscience in Anesthesia and Critical Care, An Issue of Anesthesiology Clinics, E-Book

W. Andrew Kofke

(2016)

Additional Information

Book Details

Abstract

This issue of Anesthesiology Clinics, guest edited by W. Andrew Kofke, features contributions by the Society for Neuroscience in Anesthesiology and Critical Care. Topics include: Anesthetics, Neuropathophysiology, CBF Autoregulation and Dysautoregulation, Chronic Pain in Neurosurgery, Anesthesia for Endovascular Approaches to Stroke, Pharmaclologic Innovations in Neuroanesthesia MMM, Intraoperative Monitoring, Brain Oxygen Monitoring,  Neuromuscular Disease, and more!

Table of Contents

Section Title Page Action Price
Front Cover Cover
Advances in Neuroscience in Anesthesia and Critical Care\r i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITOR iii
EDTIORS iii
AUTHORS iii
Contents vii
Foreword: Anesthesiologists as Clinical Neuroscientists—One Future for Our Specialty\r vii
Preface: Update in Neuroanesthesia—An Anesthesiology Clinics Issue Affiliated with SNACC\r vii
Basic Neuroscience William M. Armstead\r vii
General Anesthetics and Neurotoxicity: How Much Do We Know?\r vii
Neuropathophysiology of Brain Injury\r vii
Cerebral Blood Flow Autoregulation and Dysautoregulation\r vii
Anesthesia for Neurosurgery and Interventional Radiology Dhanesh K. Gupta viii
Chronic Pain in Neurosurgery\r viii
Anesthesia for Endovascular Approaches to Acute Ischemic Stroke\r viii
Neuromonitoring Martin Smith\r viii
Multimodality Neuromonitoring\r viii
Intraoperative Monitoring: Recent Advances in Motor Evoked Potentials\r ix
Brain Oxygenation Monitoring\r ix
Neurocritical Care Michael L. “Luke” James\r ix
Controversies in the Management of Traumatic Brain Injury\r ix
Subarachnoid Hemorrhage: An Update\r x
Neuromuscular Disease in the Neurointensive Care Unit\r x
ANESTHESIOLOGY CLINICS\r xi
FORTHCOMING ISSUES xi
December 2016 xi
March 2017 xi
June 2017 xi
RECENT ISSUES xi
June 2016 xi
March 2016 xi
December 2015 xi
Foreword:\rAnesthesiologists as Clinical Neuroscientists—One Future for Our Specialty xiii
Preface:\rUpdate in Neuroanesthesia—An Anesthesiology Clinics Issue Affiliated with SNACC xv
REFERENCES xvii
General Anesthetics and Neurotoxicity 439
Key points 439
INTRODUCTION 439
THE PHYSIOLOGY OF NEUROTRANSMITTERS AND THEIR RECEPTORS DURING BRAIN DEVELOPMENT 439
UNPHYSIOLOGIC MODULATION OF THE NEUROTRANSMITTERS AND THEIR RECEPTOR SYSTEMS DURING BRAIN DEVELOPMENT MAY RESULT IN NEUROTO ... 440
THE NEUROTOXIC POTENTIAL OF GENERAL ANESTHETICS IN THE DEVELOPING MAMMALIAN BRAIN 441
THE IMPORTANCE OF ANESTHESIA-INDUCED MODULATION OF NEUROTRANSMITTERS IN THE FORMATION OF NEURONAL NETWORKS 442
EXCESSIVE MODULATION OF NEUROTRANSMITTERS DURING CRITICAL STAGES OF BRAIN DEVELOPMENT AND LONG-TERM EFFECTS ON ANIMAL BEHAVIOR 442
GENERAL ANESTHESIA AND COGNITIVE AND BEHAVIORAL DEVELOPMENT IN HUMANS AFTER CHILDHOOD SURGERY 446
GENERAL ANESTHESIA AND THE AGING BRAIN 448
SUMMARY 448
REFERENCES 449
Neuropathophysiology of Brain Injury 453
Key points 453
MECHANISMS OF INJURY FOLLOWING BRAIN ISCHEMIA 454
Excitotoxicity 454
Acidotoxicity 454
Oxidative Stress 455
Inflammation 455
Apoptosis 456
Translation of these injury mechanisms to neuroprotection in humans 457
INTERCELLULAR INTERACTIONS AND REPAIR 457
Neurovascular Unit 457
Neuroinflammation 458
FUNCTIONAL PLASTICITY 459
Excitation/Inhibition Imbalance 459
Synaptic Plasticity 460
Structural Plasticity 461
SUMMARY 461
REFERENCES 462
Cerebral Blood Flow Autoregulation and Dysautoregulation 465
Key points 465
INTRODUCTION 465
MECHANISM OF AUTOREGULATION 466
METHODS USED FOR ASSESSMENT OF AUTOREGULATION 466
CLINICAL APPLICATIONS OF AUTOREGULATION TESTING 467
EFFECT OF ANESTHETICS ON AUTOREGULATION 467
PATHOPHYSIOLOGY OF CEREBRAL AUTOREGULATION IN TRAUMATIC BRAIN INJURY: OUTCOME AND TREATMENT 467
ROLE OF AGE AND SEX IN CEREBRAL AUTOREGULATION, DYSAUTOREGULATION, AND ITS TREATMENT AFTER TRAUMATIC BRAIN INJURY 468
Clinical Studies 468
Basic Science Studies 471
SUMMARY 473
REFERENCES 473
Chronic Pain in Neurosurgery 479
Key points 479
INTRODUCTION 479
PATIENT EVALUATION 481
PHARMACOLOGIC TREATMENT OPTIONS 484
NONSTEROIDAL ANTIINFLAMMATORY DRUGS AND ACETAMINOPHEN 485
Ketamine 486
Lidocaine 486
Corticosteroids 487
Dexmedetomidine 487
Gabapentin and Pregabalin 487
OPIOID MANAGEMENT 487
NONINTRAVENOUS PHARMACOLOGIC TREATMENT OPTIONS 488
NEURAXIAL ANESTHESIA FOR LUMBAR LAMINECTOMY OF DISC SURGERY 488
Scalp Block 489
Infiltration 489
SUMMARY 489
REFERENCES 490
Anesthesia for Endovascular Approaches to Acute Ischemic Stroke 497
Key points 497
INTRODUCTION 497
ANESTHETIC MANAGEMENT 498
HEMODYNAMIC MEASURES 500
NEUROPROTECTION 502
GLYCEMIC CONTROL 504
COMPLICATIONS OF INTRAVASCULAR TREATMENT OF ACUTE ISCHEMIC STROKE 505
REFERENCES 505
Multimodality Neuromonitoring 511
Key points 511
INTRODUCTION 511
INTRACRANIAL PRESSURE 512
Intracranial Monitoring Methods 512
Indications for Intracranial Pressure Monitoring 513
Intracranial Pressure Monitoring–Guided Treatment 513
Cerebral Perfusion Pressure 515
Cerebral Perfusion Pressure–Guided Treatment 515
CEREBROVASCULAR REACTIVITY 515
Pressure Reactivity Index 516
Other Autoregulatory Indices 516
Autoregulation-Guided Treatment 516
CEREBRAL BLOOD FLOW MONITORING 517
Transcranial Doppler Ultrasonography 517
Indications 517
Thermal Diffusion Flowmetry 518
CEREBRAL MICRODIALYSIS 518
Interpretation of Cerebral Microdialysis Variables 518
Indications for Cerebral Microdialysis Monitoring 519
Reference Values and Thresholds for Intervention 519
Future Perspectives 520
NEUROINFORMATICS 520
SUMMARY 520
REFERENCES 521
Intraoperative Monitoring 525
Key points 525
INTRODUCTION 525
MOTOR EVOKED POTENTIAL TECHNIQUES 526
THE CORTICOSPINAL TRACT 527
THE CORTICOBULBAR PATHWAY 528
RECORDING D-WAVE RESPONSES 528
RECORDING MUSCLE RESPONSES 528
DIRECT CORTICAL STIMULATION 529
MONITORING AND MAPPING THE MOTOR CORTEX 529
MONITORING INTRACRANIAL VASCULAR LESIONS 530
MAPPING AND MONITORING SUBCORTICAL PATHOLOGY 530
MAPPING AND MONITORING THE BRAINSTEM 530
MONITORING SPINAL SURGERY 531
MONITORING INTRAMEDULLARY SPINAL CORD TUMORS 532
DEVELOPMENT OF ENHANCING MOTOR STIMULATION TECHNIQUES 532
MONITORING DURING PARTIAL NEUROMUSCULAR BLOCKADE 533
SUMMARY 533
REFERENCES 533
Brain Oxygenation Monitoring 537
Key points 537
INTRODUCTION 537
METHODS OF MONITORING CEREBRAL OXYGENATION 538
Imaging Techniques 538
Jugular Venous Oxygen Saturation Monitoring 538
Brain Tissue Oxygen Tension Monitoring 539
Technical aspects 539
Indications for brain tissue oxygen tension monitoring 541
Normal brain tissue oxygen tension values and thresholds for treatment 541
Management of low brain tissue oxygen tension 544
Evidence for brain tissue oxygen tension–guided therapy on outcomes 544
Near-infrared Spectroscopy 548
Technical aspects 548
Indications 549
Normal regional cerebral oxygen saturation values and thresholds for treatment 549
Evidence of near-infrared spectroscopy–guided therapy on outcomes 549
FUTURE PERSPECTIVES 551
SUMMARY 552
REFERENCES 552
Controversies in the Management of Traumatic Brain Injury 557
Key points 557
EPIDEMIOLOGY 557
PATHOPHYSIOLOGY 558
Autoregulation 558
Phases of Brain Injury 559
CLASSIFICATION 559
Head Injury Classification Based on Clinical Examination 559
Glasgow Coma Scale 559
Pupil reactivity 560
Head Injury Classification Based on Imaging 562
Marshall Classification 562
MANAGEMENT 564
Intracranial Pressure and Multimodal Monitoring 564
Osmotherapy 566
Hypothermia 567
Decompressive Craniectomy 567
Steroids 568
Tranexamic Acid 568
OUTCOMES 569
Glasgow Outcome Scale and Extended Glasgow Outcome Scale 569
Modified Rankin Scale 570
Outcomes After Publication of the Brain Trauma Foundation Guidelines 571
REFERENCES 571
Subarachnoid Hemorrhage 577
Key points 577
INTRODUCTION 577
MANAGEMENT BEFORE ANEURYSM OBLITERATION 578
Antifibrinolytics: A Resurgence? 579
ANEURYSM OBLITERATION 587
Endovascular Evolution 587
COILING 587
Balloon-assisted Coiling 588
Stent-assisted Coiling 588
Flow Diversion 589
NEUROCRITICAL CARE 589
Neurogenic Pulmonary Edema 589
Stress Cardiomyopathy 591
Pituitary Dysfunction 592
Disorders of Sodium 592
DELAYED CEREBRAL ISCHEMIA 593
Cortical Spreading Depolarization 593
Microthrombi 594
Dysfunctional Cerebral Autoregulation 594
THERAPIES 594
Euvolemic Hypertensive Therapy 594
Calcium Channel Blockers 595
Statins 595
Glucose Management 595
SUMMARY 596
ACKNOWLEDGMENTS 596
REFERENCES 596
Index 621