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Chapter 16 - Anaesthesia for Emergency Neurosurgery

Published online by Cambridge University Press:  28 April 2020

Peter C. Whitfield
Affiliation:
Derriford Hospital, Plymouth
Jessie Welbourne
Affiliation:
University Hospitals, Plymouth
Elfyn Thomas
Affiliation:
Derriford Hospital, Plymouth
Fiona Summers
Affiliation:
Aberdeen Royal Infirmary
Maggie Whyte
Affiliation:
Aberdeen Royal Infirmary
Peter J. Hutchinson
Affiliation:
Addenbrooke’s Hospital, Cambridge
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Summary

An estimated 1.4 million people per year attend Emergency Departments in the UK following head trauma.1 Approximately 10% of these patients have a moderate or severe Traumatic Brain Injury (TBI) with a Glasgow Coma Score (GCS) <12 or <9 respectively. TBI results in more than 3600 Intensive Care admissions per year2 and remains the leading cause of mortality in patients aged under 25 with 6–10 brain injury deaths per 100 000 of population per annum.1

Type
Chapter
Information
Traumatic Brain Injury
A Multidisciplinary Approach
, pp. 197 - 206
Publisher: Cambridge University Press
Print publication year: 2020

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References

National Institute for Health and Care Excellence. Head injury: assessment and early management. NICE guideline (CG176). 2014. www.nice.org.uk/guidance/cg176Google Scholar
Harrison, DA, Prabhu, G, Grieve, R, Harvey, SE, Sadique, MZ, Gomes, M, Griggs, KA, Walmsley, E, Smith, M, Yeoman, P, Lecky, FE. Risk Adjustment In Neurocritical care (RAIN) – prospective validation of risk prediction models for adult patients with acute traumatic brain injury to use to evaluate the optimum location and comparative costs of neurocritical care: a cohort study. Health Technol. Assessment 2013;17(23).CrossRefGoogle ScholarPubMed
Teasdale, G, Jennett, B. Assessment of coma and impaired causes: a practical scale. The Lancet 1974;2:81–4.Google ScholarPubMed
Werner, C, Engelhard, K. Pathophysiology of traumatic brain injury. Br J Anaes 2007;99(1):49.CrossRefGoogle ScholarPubMed
Ghajar, J. Traumatic brain injury. The Lancet 2000;356(9233):923–9.Google Scholar
Hasler, RM, Exadaktylos, AK, Bouamra, O, Benneker, LM, Clancy, M, Sieber, R, Zimmermann, H, Lecky, F. Epidemiology and predictors of cervical spine injury in adult major trauma patients: a multicenter cohort study. J Trauma Acute Care Surg 2012;72(4):975–81.Google Scholar
Kehoe, A, Smith, JE, Bouamra, O, Edwards, A, Yates, D, Lecky, F. Older patients with traumatic brain injury present with a higher GCS score than younger patients for a given severity of injury. Emerg Med J 2016;33(6):381–5.CrossRefGoogle ScholarPubMed
Vespa, P, Bergsneider, M, Hattori, N, Wu, H-M, Huang, S-C, Martin, NA, Glenn, TC, McArthur, DL, Hovda, DA. Metabolic crisis without brain ischemia is common after traumatic brain injury: a combined microdialysis and positron emission tomography study. J Cerebral Blood Flow Metab 2005;25(6):763–74.CrossRefGoogle ScholarPubMed
Prabhu, M, Gupta, AK. Intracranial pressure. In: Gupta AK, Summors A, eds. Notes in neuroanaesthesia and critical care. Greenwich Medical Media; 2001.Google Scholar
Junger, EC, Newell, DW, Grant, GA, Avellino, AM, Ghatan, S, Douville, CM, Lam, AM, Aaslid, R, Winn, HR. Cerebral autoregulation following minor head injury. J Neurosurg 1997;86:425–32.Google Scholar
Prabhu, M, Gupta, AK. Cerebral blood flow. In: Gupta, AK, Summors, A, eds. Notes in neuroanaesthesia and critical care. Greenwich Medical Media; 2001.Google Scholar
Coles, JP, Fryer, TD, Smielewski, P, et al. Incidence and mechanisms of cerebral ischaemia in early head injury. J Cerebral Blood Flow Metab 2003;24:202–11.Google Scholar
Menon, DK. Brain ischaemia after traumatic brain injury: lessons from 1502 positron emission tomography. Curr Opin Crit Care 2006;12(2):85–9.Google Scholar
Robertson, CS, Bell, MJ, Kochanek, PM, Adelson, PD, Ruppel, RA, Carcillo, JA, Wisniewski, SR, Mi, Z, Janesko, KL, Clark, RS, Marion, DW, Graham, SH, Jackson, EK. Increased adenosine in cerebrospinal fluid after severe traumatic brain injury in infants and children: association with severity of injury and excitotoxicity. Crit Care Med 2001;29:22873393.Google Scholar
Weber, JT. Altered calcium signaling following traumatic brain injury. Front Pharmacol 2012;3(60):116.CrossRefGoogle ScholarPubMed
Manley, G, Knudson, MM, Morabito, D, Damron, S, Erickson, V, Pitts, L. Hypotension, hypoxia, and head injury: frequency, duration, and consequences. Arch Surg 2001;136(10):1118–23.Google Scholar
Lam, WH, Mackersie, A. Paediatric head injury: incidence, aetiology and management. Paediatr Anaes 1999;9:377–85.Google ScholarPubMed
Chestnut, RM, Marshall, LF, Klauber, MR, et al. The role of secondary brain injury in determining outcome from severe head injury. J Trauma 1993;34:216–22.Google Scholar
Bullock, RM, Chestnut, R, Clifton, GL, Ghajar, J, Marion, DW, Narayan, RK, Newell, DW, Pitts, LH, Rosner, MJ, Walters, BC, Wilberger, JE. Management and prognosis of severe traumatic brain injury, part 1: Guidelines for management of severe traumatic brain injury. J Neurotrauma 2000;17:451553.Google Scholar
Rosner, MJ, Rosner, SD, Johnson, AH. Cerebral perfusion pressure: management protocol and clinical results. J Neurosurg 1995;83:949–62.CrossRefGoogle ScholarPubMed
Eker, C, Asgeirsson, B, Grande, PO, Schalen, W, Nordstrom, CH. Improved outcome after severe head injury with a new therapy based on principles for brain volume regulation and preserved microcirculation. Crit Care Med 1998;26:1881–6.Google Scholar
Grande, PO, Asgeirsson, B, Nordstrom, CH. Physiologic principles for volume regulation of a tissue enclosed in a rigid shell with application to the injured brain. J Trauma Acute Care Surg 1997;42:2331.CrossRefGoogle Scholar
Robertson, CS, Valadka, AB, Hannay, HJ, Contant, CF, Gopinath, SP, Cormio, M, Uzura, M, Grossman, RG. Prevention of secondary insults after severe head injury. Crit Care Med 1999;27:2086–95.CrossRefGoogle ScholarPubMed
Robertson, CS. Management of cerebral perfusion pressure after traumatic brain injury. Anesthesiology 2001;95(6):1513–17.CrossRefGoogle ScholarPubMed
Carney, NL, Totten, AM, C, OʼReilly, Ullman, JS, Hawryluk, GW, Bell, MJ, Bratton, SL, Chesnut, R, Harris, OA, Kissoon, N, Rubiano, AM, Shutter, L, Tasker, RC, Vavilala, MS, Wilberger, J, Wright, DW, Ghajar, J. Guidelines for the management of severe traumatic brain injury, fourth edition. Neurosurgery 2017;80(1):615.CrossRefGoogle ScholarPubMed
Nguyen, H, Zaroff, JG. Neurogenic stunned myocardium. Curr Neurol Neurosci Rep 2009;9(6):486–91.CrossRefGoogle ScholarPubMed
Arieff, AI, Ayus, JC, Fraser, CL. Hyponatraemia and death or permanent brain damage in healthy children. Br Med J 1992;304:1218–22.CrossRefGoogle ScholarPubMed
Royal College of Surgeons of England. Report of the Working Party on the Management of Patients with Head Injuries. London: Royal College of Surgeons of England; 1999.Google Scholar
Fountain, DM, Kolias, AG, Lecky, FE, Bouamra, O, Lawrence, T, Adams, H, Bond, SJ, Hutchinson, PJ. Survival trends after surgery for acute subdural hematoma in adults over a 20-year period. Ann Surg 2017;265(3):590–6.Google Scholar
Tien, HC, Jung, V, Pinto, R, Mainprize, T, Scales, DC, Rizoli, SB. Reducing time-to-treatment decreases mortality of trauma patients with acute subdural hematoma. Ann Surg 2011;253(6):1178–83.CrossRefGoogle ScholarPubMed
Association of Anaesthetists of Great Britain and Ireland. Recommendations for standards of monitoring during anaesthesia and recovery, 4th edition. London: Association of Anaesthetists of Great Britain and Ireland; 2007.Google Scholar
Association of Anaesthetists of Great Britain and Ireland. Recommendations for the safe transfer of patients with brain injury. London: Association of Anaesthetists of Great Britain and Ireland; 2006.Google Scholar
Fukuda, S, Warner, DS. Cerebral protection. Br J Anaes 2007;99:1017.Google Scholar
Bowles, E, Gold, M. Rethinking the paradigm: evaluation of ketamine as a neurosurgical anesthetic. Am Assoc Nurse Anaesth 2012;80(6):445–52.Google ScholarPubMed
Fodale, V, Schifilliti, D, Practico, C, Santamaria, LB. Remifentanil and the brain. Acta Anaesth Scand 2008;52:319–26.Google Scholar
Jung, J. Airway management of patients with traumatic brain injury/C-spine injury. Kor J Anesth 2015;68(3):213–19.Google Scholar
National Institute for Health and Care Excellence. Spinal injury: assessment and initial management. NICE Guideline (NG41); 2016. www.nice.org.uk/guidance/ng41Google Scholar
Kochanek, PM, Carney, N, Adelson, PD, Ashwal, S, Bell, MJ, Bratton, S, Carson, S, et al. Cerebral perfusion pressure thresholds. In: Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents. 3rd edn. Pediatric Critical Care Medicine 2012;Supplement:24–9.Google Scholar
Griesdale, DE, Tremblay, MH, McEwen, J, Chittock, DR. Glucose control and mortality in patients with severe traumatic brain injury. Neurocrit Care 2009;11(3):311.Google Scholar
Badjatia, N. Hyperthermia and fever control in brain injury. Crit Care Med 2009;37(7):250–7.Google Scholar
Geze, S, Yilmaz, A, Tuzuner, F. The effect of scalp block and local infiltration on the haemodynamic and stress response to skull-pin placement for craniotomy. Eur J Anaesth 2009;26(4):298303.Google Scholar
Guilfoyle, MR, Helmy, A, Duane, D, Hutchinson, PJ. Regional scalp block for postcraniotomy analgesia: a systematic review and meta-analysis. Anesth Analg 2013;116(5):1093–102.Google Scholar
Scales, DC, Riva-Cambrin, J, Le, TL, Pinto, R, Cook, DJ, Granton, JT. Prophylaxis against venous thromboembolism in neurointensive care patients: survey of Canadian practice. J Crit Care 2009;24(2):176–84.Google Scholar
Rasmussen, M, Bundgaard, H, Cold, GE. Craniotomy for supratentorial brain tumors: risk factors for brain swelling after opening the dura mater. J Neurosurg 2004;101:621–6.Google Scholar
Roberts, FL, Dixon, J, Lewis, GTR, Tackley, RM, Prys Roberts, C. Induction and maintenance of propofol anaesthesia. Anaesthesia 1988;43:1417.CrossRefGoogle ScholarPubMed
Coles, J, Summors, A. Inhalational anaesthetic agents. In: Gupta, AK, Summors, A, eds. Notes in neuroanaesthesia and critical care. Greenwich Medical Media; 2001.Google Scholar
Van Aken, HK, Kampmeier, TG, Ertmer, C, Westphal, M. Fluid resuscitation in patients with traumatic brain injury: what is a SAFE approach? Curr Opin Anaesth 2012;25(5):563–5.CrossRefGoogle ScholarPubMed
Kamel, H, Navi, BB, Nakagawa, K, Hemphill, JC III, Ko, NU. Hypertonic saline versus mannitol for the treatment of elevated intracranial pressure: a meta-analysis of randomized clinical trials. Crit Care Med 2011;39(3):554–9.Google Scholar
Hockey, B, Leslie, K, Williams, D. Dexamethasone for intracranial neurosurgery and anaesthesia. J Clin Neurosci 2009;16(11):1389–93.Google Scholar
Corcoran, T, Kasza, J, Short, TG, O’loughlin, E, Chan, MT, Leslie, K, Forbes, A, Paech, M, Myles, P. Intraoperative dexamethasone does not increase the risk of postoperative wound infection: a propensity score-matched post hoc analysis of the ENIGMA-II trial (EnDEX). Br J Anaesth 2017;118(2):190–9.Google Scholar
Alderson, P, Roberts, IG. Corticosteroids for acute traumatic brain injury. Cochrane Database Syst Rev 2005;Issue 1:CD000196.Google Scholar
Kathirvel, S, Dash, HH, Bhatia, A, Subramaniam, B, Prakash, A, Shenoy, S. Effect of prophylactic ondansetron on postoperative nausea and vomiting after elective craniotomy. J Neurosurg Anesthes 2001;13:207–12.Google Scholar

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