Midazolam‐flumazenil versus propofol anaesthesia for scoliosis surgery with wake‐up tests

Koscielniak-Nielsen, Zbigniew J.; Stens-Pedersen, H. L.; Hesselbjerg, L.

doi:10.1111/j.1399-6576.1998.tb05090.x

Cited by 13 publications

(2 citation statements)

References 23 publications

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“…A number of different anaesthetic techniques for the Stagnara wake-up test have been advocated, including volatile-based anaesthesia. A Danish group, 58 in a randomized trial involving 40 patients, described the successful use of a midazolam-based anaesthetic, antagonized by¯umazenil at the time of the wake-up test, compared with a propofol infusion technique. The midazolam/¯umazenil group was found to have a shorter intraoperative wake-up time (mean 2.9 vs 16 min in the propofol group), shorter postoperative wake-up times (1.8 vs 13.9 min, respectively), and a better quality of intraoperative arousal.…”

Section: Stagnara Wake-up Testmentioning

confidence: 99%

Anaesthesia for spinal surgery in adults

Raw¹,

Beattie

Hunter³

2003

British Journal of Anaesthesia

169

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The spectrum of spinal surgery in adult life is considerable. Anaesthesia for major spinal surgery, such as spinal stabilization following trauma or neoplastic disease, or for correction of scoliosis, presents a number of challenges. The type of patients who would have been declined surgery 20 yr ago for medical reasons, are now being offered extensive procedures. They commonly have preoperative co-morbid conditions such as serious cardiovascular and respiratory impairment. Airway management may be difficult. Surgery imposes further stresses of significant blood loss, prolonged anaesthesia, and problematical postoperative pain management. The perioperative management of these patients is discussed. The advent of techniques to monitor spinal cord function has reduced postoperative neurological morbidity in these patients. The anaesthetist has an important role in facilitating these methods of monitoring.

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Section: Stagnara Wake-up Testmentioning

confidence: 99%

Anaesthesia for spinal surgery in adults

Raw¹,

Beattie

Hunter³

2003

British Journal of Anaesthesia

169

View full text Add to dashboard Cite

show abstract

“…An alternative or complement to intraoperative neuromonitoring, is the Stagnara Wake-up test to assess the anterior motor por-tion of the spinal cord. 39,49,52 However, this requires preoperative planning with the aenesthetist and a patient who can understand and comply with directions. The ankleclonus test is another intraoperative test of motor function as described by Hoppenfeld et al 43 that can be used to test anterior cord function.…”

Section: Surgical Causes Of Posci In the Thoracic Spinementioning

confidence: 99%

Prevention, identification, and treatment of perioperative spinal cord injury

Ahn¹,

Fehlings

2008

FOC

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Object In this report, the authors suggest evidence-based approaches to minimize the chance of perioperative spinal cord injury (POSCI) and optimize outcome in the event of a POSCI. Methods A systematic review of the basic science and clinical literature is presented. Results Authors of clinical studies have assessed intraoperative monitoring to minimize the chance of POSCI. Furthermore, preoperative factors and intraoperative issues that place patients at increased risk of POSCI have been identified, including developmental stenosis, ankylosing spondylitis, preexisting myelopathy, and severe deformity with spinal cord compromise. However, no studies have assessed methods to optimize outcomes specifically after POSCIs. There are a number of studies focussed on the pathophysiology of SCI and the minimization of secondary damage. These basic science and clinical studies are reviewed, and treatment options outlined in this article. Conclusions There are a number of treatment options, including maintenance of mean arterial blood pressure > 80 mm Hg, starting methylprednisolone treatment preoperatively, and multimodality monitoring to help prevent POSCI occurrence, minimize secondary damage, and potentially improve the clinical outcome of after a POSCI. Further prospective cohort studies are needed to delineate incidence rate, current practice patterns for preventing injury and minimizing the clinical consequences of POSCI, factors that may increase the risk of POSCI, and determinants of clinical outcome in the event of a POSCI.

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Anesthesia and Postoperative Management of Spinal Deformity Surgery in Growing Children

Florentino-Pineda

2011

The Growing Spine

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Midazolam‐flumazenil versus propofol anaesthesia for scoliosis surgery with wake‐up tests

Abstract: Wake-up tests can be conducted faster and better with midazolam-flumazenil sequence compared with propofol.

Cited by 13 publications

References 23 publications

Anaesthesia for spinal surgery in adults

Anaesthesia for spinal surgery in adults

Prevention, identification, and treatment of perioperative spinal cord injury

Anesthesia and Postoperative Management of Spinal Deformity Surgery in Growing Children

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