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).

Alana Flexman, MD, FRCPC

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:

  • Thank you to JNA Reviewers: In this issue, Editor-in-Chief Prof Martin Smith takes the opportunity to thank all the reviewers over the past year, many of whom are SNACC members. The Journal is grateful for the Reviewer’s time and commitment to high-quality peer review who perform this critical function for the Journal. The names of the reviewers are listed as supplemental digital content and available here.

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

  • Wang, E. MD, PhD; Wang, Lu MD; Ye, Chunyan MD; Luo, Ning MD; Zhang, Yanrong MD; Zhong, Yugui MD; Zhu, Maoen MD; Zou, Yu MD, PhD; Li, Qian MD, PhD; Li, Longyan MD, PhD; Song, Zongbin MD, PhD; Luo, Hui MD, PhD; Dai, Feng PhD; Liu, Hong MD; Gelb, Adrian W. MBChB; Guo, Qulian MD, PhD; Meng, Lingzhong MDfor the eMODIPOD Research Group. Effect of Electroencephalography Spectral Edge Frequency (SEF) and Patient State Index (PSI)-Guided Propofol-Remifentanil Anesthesia on Delirium After Laparoscopic Surgery. Journal of Neurosurgical Anesthesiology 2022; 34(2): 183-192.

This randomized controlled trial analyzed 1545 patients randomly assigned to receive propofol-remifentanil general anesthesia under either EEG-guided or usual care and evaluated the effect on incident delirium. The authors found a low incidence of delirium overall, and no difference between the EEG-guided group (1.0%) and usual care group (1.2%), risk ratio 0.89 (95% confidence interval 0.35-2.30). The authors similarly found no difference in emergence delirium and across all secondary outcomes.

This article is accompanied by an editorial that provides a useful context for these results and commentary:

Campbell, Doug BM; Short, Timothy G. MD; Chan, Matthew T.V. PhD. Postoperative Delirium: The Search for Effective Interventions. Journal of Neurosurgical Anesthesiology 2022; 34(2): 163-164.

  • Gray, Kristen BSc; Avitsian, Rafi MD, FASA; Kakumanu, Saranya MD, FRCPC; Venkatraghavan, Lashmi MD, DNB, FRCA, FRCPC; Chowdhury, Tumul MBBS, MD, DM, FRCPC. The Effects of Anesthetics on Glioma Progression. Journal of Neurosurgical Anesthesiology 2022; 34(2):168-175.

In this article, Gray et al provide a comprehensive overview of the various factors that influence glioma progression, including the evidence supporting a relationship with exposure to different anesthesia techniques. The authors also outline areas where there equipoise and further research is needed.

  • Hosmann, Arthur MD; Schnackenburg, Philipp MD; Rauscher, Steffen MD; Hopf, Andreas MD; Bohl, Isabelle MD; Engel, Adrian MD; Brugger, Jonas; Graf, Alexandra MMag.Dr; Plöchl, Walter MD; Reinprecht, Andrea MD; Gruber, Andreas MD. Brain Tissue Oxygen Response as Indicator for Cerebral Lactate Levels in Aneurysmal Subarachnoid Hemorrhage Patients. Journal of Neurosurgical Anesthesiology 2022; 34(2): 193-200.

Hosmann et al enrolled 20 severe subarachnoid hemorrhage patients undergoing continuous cerebral PbtO2 and microdialysis monitoring, and assessed their PbtO2 response to 3-minute hyperoxic challenges. The authors found that lower absolute increases in PbtO2 were associated with higher cerebral lactate concentrations, including ischemic lactate levels. The authors conclude that the 3-minute FiO2 challenge is easy to perform and provides a way to estimate cerebral lactate concentrations and risk of impending ischemia.

  • Liu, Hongtao MD; Busl, Katharina M. MD, MS, FNCS; Doré, Sylvain PhD, FAHA. Role of Dexmedetomidine in Aneurysmal Subarachnoid Hemorrhage: A Comprehensive Scoping Review. Journal of Neurosurgical Anesthesiology 2022; 34(2): 176-182.

This scoping review provides a detailed synthesis of the evidence on a potential protective role for dexmedetomidine use after subarachnoid hemorrhage. Current evidence is largely pre-clinical, with a need for future translational research to inform clinical practice.


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