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You are here: Home / SNACC Advanced Neuroanesthesia Classroom – Week 2

SNACC Advanced Neuroanesthesia Classroom – Week 2

GO TO WEEKLY OUTLINE
WEEK 1
WEEK 2
WEEK 3
WEEK 4

During week two,  the trainee will expand their knowledge to include management of complex spine surgery and awake craniotomy. They will:

  • Identify the perioperative concerns in complex spine surgery and management strategies for preventing and managing blood loss
  • Compare the use of total intravenous anesthesia (TIVA) with other anesthetic techniques when intraoperative monitoring is used
  • Discuss the advantages of multimodal analgesia for spine surgery
  • List the anesthetic considerations and potential complications for awake craniotomy

Complex spine surgery

      • Articles:
        • Management of complex spine surgery. (PMID: 28731875)
        • Extubation after Multi-level Spine Surgery (PMID: 24296539)
        • Diagnosis and Treatment of Neuroanesthetic Emergencies (PMID: 30334936)
        • ERAS for Spine Surgery (PMID: 28009223)
        • SNACC Clinical Practice Guidelines for perioperative care of patients for complex spine surgery (PMID: 34483301)
      • Clinical Audio and Video Corner
        • Anesthetic Management for Complex Spine Surgery, May 2018
      • Quiz
        • Considerations with positioning for neurosurgical procedures.

Considerations and concerns in cervical spine surgery

      • Articles
        • Injury and Liability associated with spine surgery (PMID: 28763433)
        • Cervical spine movement in a cadaveric model of severe instability: comparison of 4 different laryngoscopes, (PMID: 28230622)
        • Intubating LMA-assisted flexible bronchoscopy intubation and cervical spine motion (PMID: 30893284)
        • Dysphagia after Cervical spine surgery (PMID: 30794969)
      • Interactive case
        • Cervical Spine and Airway Issues

Managing pain in spine surgery patients

      • Quiz
        • Perioperative management in patients with Chronic pain
      • JNA Podcast
        • Opioid Alternatives in Spine Surgery (January 2022, Dr. Shilpa Rao)    
        • Article of the Month: Opioid Alternatives in Spine Surgery (PMID: 32568816)
      • Articles
        • Incidence and Risk factors for chronic postoperative opioid use after major spine surgery, (PMID:29570151)
        • Best Evidence in multimodal pain management in spine surgery (PMID: 25766366)
        • Multimodal analgesic regimen for spine surgery: a randomized placebo-controlled trial (PMID: 32235144)
        • Pain management after complex spine surgery: a systematic review and procedure-specific postoperative pain management recommendations (PMID: 34397527)
        • Intraoperative and postoperative administration of Dexmedetomidine reduces anesthetic and postoperative analgesic requirements in patients undergoing cervical spine surgeries (PMID: 27035842)

Methadone, ketamine, and dexmedetomidine for spine surgery

      • Quiz
        • Ketamine in Neuroanesthesia
      • Fellows’ and Residents’ Audio Corner
        • Multimodal analgesia for Spine Surgery (April 2022, Dr. Shobana Rajan)
      • Articles
        • Safety profile of intraoperative methadone for analgesia after major spine surgery (PMID: 29733094)
        • Perioperative methadone and ketamine for postoperative pain control in spinal surgical patients: a randomized double-blind, placebo-controlled trial (PMID: 33730151)
        • Perioperative Ketamine for analgesia for spine surgery: a Meta Analysis (PMID: 28700455)
        • Comparison of small dose Ketamine and Dexmedetomidine infusion for postoperative analgesia in spine surgery. (PMID: 26018671)

Lidocaine for pain management in spine surgery

      • Articles
        • Systematic Review and Meta-Analysis: Perioperative IV Lidocaine on complex spine surgery PMID: 33235097
          • SNACC Commentary on Article of the month, June 2015
        • Farag E., et al. Effect of perioperative intravenous lidocaine administration on pain, opioid consumption, and the quality of life after complex spine surgery (PMID: 23681143)

Regional anesthesia for spine surgery

      • Articles
        • Low thoracic erector spinae plane block for perioperative analgesia in lumbosacral spine surgery, a case series (PMID: 29704223)
        • Erector spinae plane block for spine surgery, a systemic review (PMID: 33983515)

Intraoperative electrophysiological monitoring and anesthesia for complex spine surgery

      • Interactive Neuromonitoring Clinical Cases
        • Neuromonitoring for spinal deformity surgery
        • Why can’t we get good baseline motor evoked potentials in this patient?
        • What should I plan for maintenance anesthetic if neuromonitoring is involved in this case?
      • Article
        • Introduction to intraoperative neurophysiological monitoring for anaesthetists (WFSA)

Tranexamic acid for spine surgery

      • Articles
        • Intraoperative tranexamic acid use in major spine surgery in adults (PMID: 28203735)
          • SNACC Commentary

Spine surgery for AVM/AVF resection and tumors

      • Articles
        • Anesthesia considerations and intraoperative monitoring during surgery for arteriovenous malformations and dural arteriovenous fistulas (PMID: 22107866)
        • Contemporary management of Spinal AVF’s and AVM’s, (PMID: 25175433)

 

Supplementary reading (SNACC Bibliography collection)

      • Multimodal Analgesia in Spine Surgery ( Pain Management → Multimodal Analgesia for Spine Surgery)

Anesthesia for awake craniotomy

      • Fellows’ and Residents’ Audio Corner
        • Anesthesia for awake craniotomy, (April 2017, Dr. Sergio Bergese)
          • Articles:
            • Awake Craniotomy: anesthetic considerations based on outcome evidence, (PMID: 31107256)
            • Comparison of the Asleep- Awake-Asleep technique and monitored anesthesia care during awake craniotomy, (PMID: 31972627)
            • Awake vs Asleep motor mapping for glioma resection, (PMID: 32388682)
            • Cognitive and linguistic outcomes after awake craniotomy, (PMID: 32738586)
            • Feasibility of Awake craniotomy in the pediatric population, (PMID: 32856774)
            • Dexmedetomidine as adjunct in awake craniotomy, (PMID: 32090308)

Challenges during awake craniotomy

      • Articles
        • Awake craniotomy in a patient with previously diagnosed PTSD, (PMID: 32278819)
        • Awake craniotomy: improving the patient’s experience, (PMID: 26263121)
        • Intraoperative Seizures during Awake Craniotomy, (PMID: 23615101)
        • Awake Craniotomy in low resource settings. (PMID: 33091650)
        • Awake craniotomy under 3-Tesla intraoperative MRI imaging, (PMID: 32482989)

Challenging cases: SNACC Newsletter

    • (Spring Newsletter 2019): Awake craniotomy in a patient with history of Malignant Hyperthermia.
    • (Winter Newsletter 2018): Awake craniotomy in the intraoperative MRI suite.
    • (Fall Newsletter 2018): Awake craniotomy for an aterio-venous malformation in the eloquent area.

   SNACC Bibliography collection :

  • Awake Craniotomy (Neurosurgery → Awake Craniotomy)
  • Managing Craniotomy pain (Pain Management → Post-Craniotomy Pain Syndromes)
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