Editor’s Picks: Highlights from the Journal of Neurosurgical Anesthesiology


As the official journal of SNACC, the Journal of Neurosurgical Anesthesiology has a long history of publishing original and review articles relevant to the SNACC membership. Dr. Martin Smith is the Editor-in-Chief. Subscribe to the JNA e-Table of Contents here and follow JNA on Twitter (@JNeurosurgAnes). 

By Alana Flexman, MD, FRCPC
SNACC Representative to the JNA Editorial Board & JNA Associate Editor 

 We are pleased to share several updates from the Journal of Neurosurgical Anesthesiology with the SNACC membership: 

  • New JNA Article Format: The current issue of JNA contains the first Focused Review, a new article formal for the Journal. These reviews are concise, evidenced-based commentaries on topics relevant to those working in perioperative neuroscience and related disciplines. Focused reviews will summarize the recent literature, highlight implications for clinical practice and patient outcomes, and identify knowledge gaps.  
  • Celebrating SNACC’s 50th Anniversary: Take a moment to read all about the history and accomplishments of SNACC in our 50th anniversary year in a special editorial by Drs. Abjeco, Cottrell and Paisansathan – more celebration to come at the upcoming SNACC Annual Meeting! 

The July issue of the Journal will feature several Editor’s Picks that are free to access:  

  • Focused review: Abcejo, Arnoley S. MD; Pasternak, Jeffrey J. MD Under the Helmet: Perioperative Concussion—Review of Current Literature and Targets for Research. Journal of Neurosurgical Anesthesiology 2022; 34(3) 

In the inaugural JNA Focused Review, Drs. Pasternak and Abcejo provide us a with a “look under the helmet” at the current literature on perioperative concussion and management. Easily digestible, this informative review can be enjoyed during your next coffee break! 

  • Lele, Abhijit V. MBBS, MD, MS, FNCS*; Furman, Michele R.EEG/EPT, CNIM; Myers, Jonathan MD, PhD*; Kinney, Greg PhD; Sharma, Deepak MD, DM*; Hecker, James MD, PhD* Inadvertent Burst Suppression During Total Intravenous Anesthesia in 112 Consecutive Patients Undergoing Spinal Instrumentation Surgery. Journal of Neurosurgical Anesthesiology 2022; 2022; 34(3) 

In this audit of over a one hundred spine surgery patients, Lele et al found high rates and prolonged periods of inadvertent burst suppression, even in the presence of intraoperative EEG monitoring. The authors call for further research into the implications of these findings.  

  • Flexman, Alana M. MD, FRCPC*; Kim, Clara N.H. BSc; Plyley, Tyler MD; Vila-Rodriguez, Fidel MD, PhD, FRCPC§; Gelb, Adrian W. MBChB, FRCPC; Field, Thalia S. MD, MHSc, FRCPC Postoperative Screening With the Modified National Institutes of Health Stroke Scale After Noncardiac Surgery. Journal of Neurosurgical Anesthesiology 2022; 2022; 34(3) 

In this pilot study, the modified NIH Stroke Screening Scale (mNIHSS) was applied to 25 older non-cardiac surgical patients. The authors found that the changes in the mNIHSS can occur in the absence of stroke early after surgery, and further research is required to establish the optimal way to screen for perioperative stroke.  

This article is accompanied by an Editorial by Meng et al highlighting the limitations of the mNIHSS, and a proposal for an algorithm to screen for stroke with the mNIHSS: 

Meng, Lingzhong MD*; Zhao, Xu MD; Rasmussen, Mads MD, PhD Revised Use of the Modified National Institutes of Health Stroke Scale for Perioperative Stroke Screening. Journal of Neurosurgical Anesthesiology 2022; 2022; 34(3) 

  • Patel, Kishan K. BS*; Sun, Xin MSPH*; Cheng, Joseph MD; Schaller, Karl MD; Tessitore, Enrico MD; Gondar, Renato MD; Gaudet, John MD§; Myles, Paul S. DSc; Leslie, Kate MD; Nouri, Aria MD Safety of Nitrous Oxide Anesthesia in a Selected Group of Patients Undergoing Neurosurgery. Journal of Neurosurgical Anesthesiology 2022; 2022; 34(3) 

This interesting study examined a subgroup of the ENIGMA Trial to explore the safety of nitrous oxide in patients undergoing neurosurgery. Reassuringly, the authors found that the use of nitrous oxide did not increase the risk of postoperative complications or length of stay in this cohort.  





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