Effect of nitrous oxide use on long-term neurologic and neuropsychological outcome in patients who received temporary proximal artery occlusion during cerebral aneurysm clipping surgery

Jeffrey J. Pasternak, Diana G. McGregor, William L. Lanier, Darrell R. Schroeder, Deborah A. Rusy, Bradley Hindman, William Clarke, James Torner, Michael M. Todd, K. Chaloner, P. Davis, D. Tranel, J. Winn, M. Wichman, R. Peters, M. Hansen, D. Anderson, J. Lang, B. Yoo, H. Adams & 491 others G. Clifton, D. Warner, R. Frankowski, K. Kieburtz, Donald Prough, L. Sternau, J. Marler, C. Moy, B. Radziszewska, B. Matta, P. Kirkpatrick, D. Chatfield, C. Skilbeck, R. Kirollos, F. Rasulo, K. English, C. Duffy, K. Pedersen, N. Scurrah, R. Burnstein, A. Prabhu, C. Salmond, A. Blackwell, J. Birrell, S. Jackson, N. Kassell, T. Pajewski, H. Fraley, A. Morris, T. Alden, M. Shaffrey, D. Bogdonoff, M. Durieux, Z. Zuo, K. Littlewood, E. Nemergut, R. Bedford, D. Stone, P. Balestrieri, J. Mason, G. Henry, P. Ting, J. Shafer, T. Blount, L. Kim, A. James, E. Farace, L. Clark, M. Irons, T. Sasaki, K. Webb, T. Short, E. Mee, J. Ormrod, J. Jane, T. Alden, P. Heppner, S. Olson, D. Ellegala, C. Lind, J. Sheehan, M. Woodfield, A. Law, M. Harrison, P. Davies, D. Campbell, N. Robertson, R. Fry, D. Sage, S. Laurent, C. Bradfield, K. Pedersen, K. Smith, Y. Young, C. Chambers, B. Hodkinson, J. Biddulph, L. Jensen, J. Ogden, Z. Thayer, F. Lee, S. Crump, J. Quaedackers, A. Wray, V. Roelfsema, R. Greif, G. Kleinpeter, C. Lothaller, E. Knosp, W. Pfisterer, R. Schatzer, C. Salem, W. Kutalek, E. Tuerkkan, L. Koller, T. Weber, A. Buchmann, C. Merhaut, M. Graf, B. Rapf, A. Lam, D. Newell, P. Tanzi, L. Lee, K. Domino, M. Vavilala, J. Bramhall, M. Souter, G. Britz, H. Winn, H. Bybee, T. Costello, M. Murphy, K. Harris, C. Thien, D. Nye, T. Han, P. McNeill, B. O'Brien, J. Cormack, A. Wyss, R. Grauer, R. Popovic, S. Jones, R. Deam, G. Heard, R. Watson, L. Evered, F. Bardenhagen, C. Meade, J. Haartsen, J. Kruger, M. Wilson, M. Maktabi, V. Traynelis, A. McAllister, P. Leonard, B. Hindman, J. Brian, F. Mensink, R. From, D. Papworth, P. Schmid, D. Dehring, M. Howard, P. Hitchon, J. VanGilder, J. Weeks, L. Moss, K. Manzel, S. Anderson, R. Tack, D. Taggard, P. Lennarson, M. Menhusen, A. Gelb, S. Lownie, R. Craen, T. Novick, G. Ferguson, N. Duggal, J. Findlay, W. Ng, D. Cowie, N. Badner, I. Herrick, H. Smith, G. Heard, R. Peterson, J. Howell, L. Lindsey, L. Carriere, M. von Lewinski, B. Schaefer, D. Bisnaire, P. Doyle-Pettypiece, M. McTaggart, A. Gelb, W. Young, S. Giannotta, V. Zelman, E. Thomson, E. Babayan, C. McCleary, D. Fishback, S. Samra, B. Thompson, W. Chandler, J. Mcgillicuddy, K. Tremper, C. Turner, P. Smythe, E. Dy, S. Pai, V. Portman, J. Palmisano, D. Auer, M. Quigley, B. Giordani, A. Freymuth, P. Scott, R. Silbergleit, S. Hickenbottom, L. Litt, M. Lawton, L. Hannegan, D. Gupta, P. Bickler, B. Dodson, P. Talke, I. Rampil, B. Chen, P. Wright, J. Mitchell, S. Ryan, J. Walker, N. Quinnine, C. Applebury, P. Myles, J. Rosenfeld, J. Hunt, S. Wallace, P. D'Urso, C. Thien, J. McMahon, S. Wadanamby, K. Siu, G. Malham, J. Laidlaw, S. Salerno, S. Alatakis, H. Madder, S. Cairo, A. Konstantatos, J. Smart, D. Lindholm, D. Bain, H. Machlin, J. Moloney, M. Buckland, A. Silvers, G. Downey, A. Molnar, M. Langley, D. McIlroy, D. Daly, P. Bennett, L. Forlano, R. Testa, W. Burnett, F. Johnson, M. Angliss, H. Fletcher, P. Manninen, M. Wallace, K. Lukitto, M. Tymianski, P. Porter, F. Gentili, H. El-Beheiry, M. Mosa, P. Mak, M. Balki, S. Shaikh, R. Sawyer, K. Quader, R. Chelliah, P. Berklayd, N. Merah, G. Ghazali, M. McAndrews, J. Ridgley, O. Odukoya, S. Yantha, J. Wilson, P. Petrozza, C. Miller, K. O'Brien, C. Tong, M. Olympio, J. Reynolds, D. Colonna, S. Glazier, S. Nobles, D. Hill, H. Hulbert, W. Jenkins, D. Piepgras, R. Wilson, F. Meyer, J. Atkinson, M. Link, M. Weglinski, K. Berge, M. Trenerry, G. Smith, J. Walkes, M. Felmlee-Devine, H. Van Aken, C. Greiner, H. Freise, H. Brors, K. Hahnenkamp, N. Monteirode Oliveira, C. Schul, D. Moskopp, J. Woelfer, C. Hoenemann, H. Gramke, H. Bone, I. Gibmeier, S. Wirtz, H. Lohmann, J. Freyhoff, B. Bauer, K. Hogan, R. Dempsey, B. Badie, B. Iskandar, D. Resnick, P. Deshmukh, J. Fitzpatrick, F. Sasse, T. Broderick, K. Willmann, L. Connery, J. Kish, C. Weasler, N. Page, B. Hermann, J. Jones, D. Dulli, H. Stanko, M. Geraghty, R. Elbe, F. Salevsky, R. Leblanc, N. Lapointe, H. MacGregor, D. Sinclair, D. Sirhan, M. Maleki, M. Abou-Madi, D. Chartrand, M. Angle, D. Milovan, Y. Painchaud, M. Mirski, R. Tamargo, S. Rice, A. Olivi, D. Kim, D. Rigamonti, N. Naff, M. Hemstreet, L. Berkow, P. Chery, J. Ulatowski, L. Moore, T. Cunningham, N. McBee, T. Hartman, J. Heidler, A. Hillis, E. Tuffiash, C. Chase, A. Kane, D. Greene-Chandos, M. Torbey, W. Ziai, K. Lane, Anish Bhardwaj, N. Subhas, A. Schubert, M. Mayberg, M. Beven, P. Rasmussen, H. Woo, S. Bhatia, Z. Ebrahim, M. Lotto, F. Vasarhelyi, J. Munis, K. Graves, J. Woletz, G. Chelune, S. Samples, J. Evans, D. Blair, A. Abou-Chebl, F. Shutway, D. Manke, C. Beven, P. Fogarty-Mack, P. Stieg, R. Eliazo, P. Li, H. Riina, C. Lien, L. Ravdin, J. Wang, Y. Kuo, R. Jaffe, G. Steinberg, D. Luu, S. Chang, R. Giffard, H. Lemmens, R. Morgan, A. Mathur, M. Angst, A. Meyer, H. Yi, P. Karzmark, T. Bell-Stephens, M. Marcellus, J. Sneyd, L. Pobereskin, S. Salsbury, P. Whitfield, R. Sawyer, A. Dashfield, R. Struthers, P. Davies, A. Rushton, V. Petty, S. Harding, E. Richardson, H. Yonas, F. Gyulai, L. Kirby, A. Kassam, N. Bircher, L. Meng, J. Krugh, G. Seever, R. Hendrickson, J. Gebel, D. Cowie, G. Fabinyi, S. Poustie, G. Davis, A. Drnda, D. Chandrasekara, J. Sturm, T. Phan, A. Shelton, M. Clausen, S. Micallef, A. Sills, F. Steinman, P. Sutton, J. Sanders, D. Van Alstine, D. Leggett, E. Cunningham, W. Hamm, B. Frankel, J. Sorenson, L. Atkins, A. Redmond, S. Dalrymple, S. Black, W. Fisher, C. Hall, D. Wilhite, T. Moore, P. Blanton, Z. Sha, P. Szmuk, D. Kim, A. Ashtari, C. Hagberg, M. Matuszczak, A. Shahen, O. Moise, D. Novy, R. Govindaraj, L. Jameson, R. Breeze, I. Awad, R. Mattison, T. Anderson, L. Salvia, M. Mosier, C. Loftus, J. Smith, W. Lilley, B. White, M. Lenaerts, C. Loftus

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

BACKGROUND: The authors explored the relationship between nitrous oxide use and neurologic and neuropsychological outcome in a population of patients likely to experience intraoperative cerebral ischemia: those who had temporary cerebral arterial occlusion during aneurysm clipping surgery. METHODS: A post hoc analysis of a subset of the data from the Intraoperative Hypothermia for Aneurysm Surgery Trial was conducted. Only subjects who had temporary arterial occlusion during surgery were included in the analysis. Metrics of short-term and long-term (i.e., 3 months after surgery) outcome were evaluated via both univariate and multivariate logistic regression analysis. An odds ratio (OR) greater than 1.0 denotes a worse outcome in patients receiving nitrous oxide. RESULTS: The authors evaluated 441 patients, of which 199 received nitrous oxide. Patients receiving nitrous oxide had a greater risk of delayed ischemic neurologic deficits (i.e., the clinical manifestation of vasospasm) (OR, 1.78, 95% confidence interval [CI], 1.08-2.95; P = 0.025). However, at 3 months after surgery, there was no difference in any metric of gross neurologic outcome: Glasgow Outcome Score (OR, 0.67; CI, 0.44-1.03; P = 0.065), Rankin Score (OR, 0.74; CI, 0.47-1.16; P = 0.192), National Institutes of Health Stroke Scale (OR, 1.02; CI, 0.66-1.56; P = 0.937), or Barthel Index (OR, 0.69; CI, 0.38-1.25; P = 0.22). The risk of impairment on at least one test of neuropsychological function was reduced in those who received nitrous oxide (OR, 0.56; CI, 0.36-0.89; P = 0.013). CONCLUSION: In this patient population, use of nitrous oxide was associated with an increased risk for the development of delayed ischemic neurologic deficits; however, there was no evidence of detriment to long-term gross neurologic or neuropsychological outcome.

Original languageEnglish (US)
Pages (from-to)563-573
Number of pages11
JournalAnesthesiology
Volume110
Issue number3
DOIs
StatePublished - Mar 2009

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Nitrous Oxide
Intracranial Aneurysm
Nervous System
Arteries
Odds Ratio
Confidence Intervals
Neurologic Manifestations
Aneurysm
Neuropsychological Tests
National Institutes of Health (U.S.)
Hypothermia
Brain Ischemia
Population
Logistic Models
Stroke
Regression Analysis

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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Effect of nitrous oxide use on long-term neurologic and neuropsychological outcome in patients who received temporary proximal artery occlusion during cerebral aneurysm clipping surgery. / Pasternak, Jeffrey J.; McGregor, Diana G.; Lanier, William L.; Schroeder, Darrell R.; Rusy, Deborah A.; Hindman, Bradley; Clarke, William; Torner, James; Todd, Michael M.; Chaloner, K.; Davis, P.; Tranel, D.; Winn, J.; Wichman, M.; Peters, R.; Hansen, M.; Anderson, D.; Lang, J.; Yoo, B.; Adams, H.; Clifton, G.; Warner, D.; Frankowski, R.; Kieburtz, K.; Prough, Donald; Sternau, L.; Marler, J.; Moy, C.; Radziszewska, B.; Matta, B.; Kirkpatrick, P.; Chatfield, D.; Skilbeck, C.; Kirollos, R.; Rasulo, F.; English, K.; Duffy, C.; Pedersen, K.; Scurrah, N.; Burnstein, R.; Prabhu, A.; Salmond, C.; Blackwell, A.; Birrell, J.; Jackson, S.; Kassell, N.; Pajewski, T.; Fraley, H.; Morris, A.; Alden, T.; Shaffrey, M.; Bogdonoff, D.; Durieux, M.; Zuo, Z.; Littlewood, K.; Nemergut, E.; Bedford, R.; Stone, D.; Balestrieri, P.; Mason, J.; Henry, G.; Ting, P.; Shafer, J.; Blount, T.; Kim, L.; James, A.; Farace, E.; Clark, L.; Irons, M.; Sasaki, T.; Webb, K.; Short, T.; Mee, E.; Ormrod, J.; Jane, J.; Alden, T.; Heppner, P.; Olson, S.; Ellegala, D.; Lind, C.; Sheehan, J.; Woodfield, M.; Law, A.; Harrison, M.; Davies, P.; Campbell, D.; Robertson, N.; Fry, R.; Sage, D.; Laurent, S.; Bradfield, C.; Pedersen, K.; Smith, K.; Young, Y.; Chambers, C.; Hodkinson, B.; Biddulph, J.; Jensen, L.; Ogden, J.; Thayer, Z.; Lee, F.; Crump, S.; Quaedackers, J.; Wray, A.; Roelfsema, V.; Greif, R.; Kleinpeter, G.; Lothaller, C.; Knosp, E.; Pfisterer, W.; Schatzer, R.; Salem, C.; Kutalek, W.; Tuerkkan, E.; Koller, L.; Weber, T.; Buchmann, A.; Merhaut, C.; Graf, M.; Rapf, B.; Lam, A.; Newell, D.; Tanzi, P.; Lee, L.; Domino, K.; Vavilala, M.; Bramhall, J.; Souter, M.; Britz, G.; Winn, H.; Bybee, H.; Costello, T.; Murphy, M.; Harris, K.; Thien, C.; Nye, D.; Han, T.; McNeill, P.; O'Brien, B.; Cormack, J.; Wyss, A.; Grauer, R.; Popovic, R.; Jones, S.; Deam, R.; Heard, G.; Watson, R.; Evered, L.; Bardenhagen, F.; Meade, C.; Haartsen, J.; Kruger, J.; Wilson, M.; Maktabi, M.; Traynelis, V.; McAllister, A.; Leonard, P.; Hindman, B.; Brian, J.; Mensink, F.; From, R.; Papworth, D.; Schmid, P.; Dehring, D.; Howard, M.; Hitchon, P.; VanGilder, J.; Weeks, J.; Moss, L.; Manzel, K.; Anderson, S.; Tack, R.; Taggard, D.; Lennarson, P.; Menhusen, M.; Gelb, A.; Lownie, S.; Craen, R.; Novick, T.; Ferguson, G.; Duggal, N.; Findlay, J.; Ng, W.; Cowie, D.; Badner, N.; Herrick, I.; Smith, H.; Heard, G.; Peterson, R.; Howell, J.; Lindsey, L.; Carriere, L.; von Lewinski, M.; Schaefer, B.; Bisnaire, D.; Doyle-Pettypiece, P.; McTaggart, M.; Gelb, A.; Young, W.; Giannotta, S.; Zelman, V.; Thomson, E.; Babayan, E.; McCleary, C.; Fishback, D.; Samra, S.; Thompson, B.; Chandler, W.; Mcgillicuddy, J.; Tremper, K.; Turner, C.; Smythe, P.; Dy, E.; Pai, S.; Portman, V.; Palmisano, J.; Auer, D.; Quigley, M.; Giordani, B.; Freymuth, A.; Scott, P.; Silbergleit, R.; Hickenbottom, S.; Litt, L.; Lawton, M.; Hannegan, L.; Gupta, D.; Bickler, P.; Dodson, B.; Talke, P.; Rampil, I.; Chen, B.; Wright, P.; Mitchell, J.; Ryan, S.; Walker, J.; Quinnine, N.; Applebury, C.; Myles, P.; Rosenfeld, J.; Hunt, J.; Wallace, S.; D'Urso, P.; Thien, C.; McMahon, J.; Wadanamby, S.; Siu, K.; Malham, G.; Laidlaw, J.; Salerno, S.; Alatakis, S.; Madder, H.; Cairo, S.; Konstantatos, A.; Smart, J.; Lindholm, D.; Bain, D.; Machlin, H.; Moloney, J.; Buckland, M.; Silvers, A.; Downey, G.; Molnar, A.; Langley, M.; McIlroy, D.; Daly, D.; Bennett, P.; Forlano, L.; Testa, R.; Burnett, W.; Johnson, F.; Angliss, M.; Fletcher, H.; Manninen, P.; Wallace, M.; Lukitto, K.; Tymianski, M.; Porter, P.; Gentili, F.; El-Beheiry, H.; Mosa, M.; Mak, P.; Balki, M.; Shaikh, S.; Sawyer, R.; Quader, K.; Chelliah, R.; Berklayd, P.; Merah, N.; Ghazali, G.; McAndrews, M.; Ridgley, J.; Odukoya, O.; Yantha, S.; Wilson, J.; Petrozza, P.; Miller, C.; O'Brien, K.; Tong, C.; Olympio, M.; Reynolds, J.; Colonna, D.; Glazier, S.; Nobles, S.; Hill, D.; Hulbert, H.; Jenkins, W.; Piepgras, D.; Wilson, R.; Meyer, F.; Atkinson, J.; Link, M.; Weglinski, M.; Berge, K.; Trenerry, M.; Smith, G.; Walkes, J.; Felmlee-Devine, M.; Van Aken, H.; Greiner, C.; Freise, H.; Brors, H.; Hahnenkamp, K.; Monteirode Oliveira, N.; Schul, C.; Moskopp, D.; Woelfer, J.; Hoenemann, C.; Gramke, H.; Bone, H.; Gibmeier, I.; Wirtz, S.; Lohmann, H.; Freyhoff, J.; Bauer, B.; Hogan, K.; Dempsey, R.; Badie, B.; Iskandar, B.; Resnick, D.; Deshmukh, P.; Fitzpatrick, J.; Sasse, F.; Broderick, T.; Willmann, K.; Connery, L.; Kish, J.; Weasler, C.; Page, N.; Hermann, B.; Jones, J.; Dulli, D.; Stanko, H.; Geraghty, M.; Elbe, R.; Salevsky, F.; Leblanc, R.; Lapointe, N.; MacGregor, H.; Sinclair, D.; Sirhan, D.; Maleki, M.; Abou-Madi, M.; Chartrand, D.; Angle, M.; Milovan, D.; Painchaud, Y.; Mirski, M.; Tamargo, R.; Rice, S.; Olivi, A.; Kim, D.; Rigamonti, D.; Naff, N.; Hemstreet, M.; Berkow, L.; Chery, P.; Ulatowski, J.; Moore, L.; Cunningham, T.; McBee, N.; Hartman, T.; Heidler, J.; Hillis, A.; Tuffiash, E.; Chase, C.; Kane, A.; Greene-Chandos, D.; Torbey, M.; Ziai, W.; Lane, K.; Bhardwaj, Anish; Subhas, N.; Schubert, A.; Mayberg, M.; Beven, M.; Rasmussen, P.; Woo, H.; Bhatia, S.; Ebrahim, Z.; Lotto, M.; Vasarhelyi, F.; Munis, J.; Graves, K.; Woletz, J.; Chelune, G.; Samples, S.; Evans, J.; Blair, D.; Abou-Chebl, A.; Shutway, F.; Manke, D.; Beven, C.; Fogarty-Mack, P.; Stieg, P.; Eliazo, R.; Li, P.; Riina, H.; Lien, C.; Ravdin, L.; Wang, J.; Kuo, Y.; Jaffe, R.; Steinberg, G.; Luu, D.; Chang, S.; Giffard, R.; Lemmens, H.; Morgan, R.; Mathur, A.; Angst, M.; Meyer, A.; Yi, H.; Karzmark, P.; Bell-Stephens, T.; Marcellus, M.; Sneyd, J.; Pobereskin, L.; Salsbury, S.; Whitfield, P.; Sawyer, R.; Dashfield, A.; Struthers, R.; Davies, P.; Rushton, A.; Petty, V.; Harding, S.; Richardson, E.; Yonas, H.; Gyulai, F.; Kirby, L.; Kassam, A.; Bircher, N.; Meng, L.; Krugh, J.; Seever, G.; Hendrickson, R.; Gebel, J.; Cowie, D.; Fabinyi, G.; Poustie, S.; Davis, G.; Drnda, A.; Chandrasekara, D.; Sturm, J.; Phan, T.; Shelton, A.; Clausen, M.; Micallef, S.; Sills, A.; Steinman, F.; Sutton, P.; Sanders, J.; Van Alstine, D.; Leggett, D.; Cunningham, E.; Hamm, W.; Frankel, B.; Sorenson, J.; Atkins, L.; Redmond, A.; Dalrymple, S.; Black, S.; Fisher, W.; Hall, C.; Wilhite, D.; Moore, T.; Blanton, P.; Sha, Z.; Szmuk, P.; Kim, D.; Ashtari, A.; Hagberg, C.; Matuszczak, M.; Shahen, A.; Moise, O.; Novy, D.; Govindaraj, R.; Jameson, L.; Breeze, R.; Awad, I.; Mattison, R.; Anderson, T.; Salvia, L.; Mosier, M.; Loftus, C.; Smith, J.; Lilley, W.; White, B.; Lenaerts, M.; Loftus, C.

In: Anesthesiology, Vol. 110, No. 3, 03.2009, p. 563-573.

Research output: Contribution to journalArticle

Pasternak, JJ, McGregor, DG, Lanier, WL, Schroeder, DR, Rusy, DA, Hindman, B, Clarke, W, Torner, J, Todd, MM, Chaloner, K, Davis, P, Tranel, D, Winn, J, Wichman, M, Peters, R, Hansen, M, Anderson, D, Lang, J, Yoo, B, Adams, H, Clifton, G, Warner, D, Frankowski, R, Kieburtz, K, Prough, D, Sternau, L, Marler, J, Moy, C, Radziszewska, B, Matta, B, Kirkpatrick, P, Chatfield, D, Skilbeck, C, Kirollos, R, Rasulo, F, English, K, Duffy, C, Pedersen, K, Scurrah, N, Burnstein, R, Prabhu, A, Salmond, C, Blackwell, A, Birrell, J, Jackson, S, Kassell, N, Pajewski, T, Fraley, H, Morris, A, Alden, T, Shaffrey, M, Bogdonoff, D, Durieux, M, Zuo, Z, Littlewood, K, Nemergut, E, Bedford, R, Stone, D, Balestrieri, P, Mason, J, Henry, G, Ting, P, Shafer, J, Blount, T, Kim, L, James, A, Farace, E, Clark, L, Irons, M, Sasaki, T, Webb, K, Short, T, Mee, E, Ormrod, J, Jane, J, Alden, T, Heppner, P, Olson, S, Ellegala, D, Lind, C, Sheehan, J, Woodfield, M, Law, A, Harrison, M, Davies, P, Campbell, D, Robertson, N, Fry, R, Sage, D, Laurent, S, Bradfield, C, Pedersen, K, Smith, K, Young, Y, Chambers, C, Hodkinson, B, Biddulph, J, Jensen, L, Ogden, J, Thayer, Z, Lee, F, Crump, S, Quaedackers, J, Wray, A, Roelfsema, V, Greif, R, Kleinpeter, G, Lothaller, C, Knosp, E, Pfisterer, W, Schatzer, R, Salem, C, Kutalek, W, Tuerkkan, E, Koller, L, Weber, T, Buchmann, A, Merhaut, C, Graf, M, Rapf, B, Lam, A, Newell, D, Tanzi, P, Lee, L, Domino, K, Vavilala, M, Bramhall, J, Souter, M, Britz, G, Winn, H, Bybee, H, Costello, T, Murphy, M, Harris, K, Thien, C, Nye, D, Han, T, McNeill, P, O'Brien, B, Cormack, J, Wyss, A, Grauer, R, Popovic, R, Jones, S, Deam, R, Heard, G, Watson, R, Evered, L, Bardenhagen, F, Meade, C, Haartsen, J, Kruger, J, Wilson, M, Maktabi, M, Traynelis, V, McAllister, A, Leonard, P, Hindman, B, Brian, J, Mensink, F, From, R, Papworth, D, Schmid, P, Dehring, D, Howard, M, Hitchon, P, VanGilder, J, Weeks, J, Moss, L, Manzel, K, Anderson, S, Tack, R, Taggard, D, Lennarson, P, Menhusen, M, Gelb, A, Lownie, S, Craen, R, Novick, T, Ferguson, G, Duggal, N, Findlay, J, Ng, W, Cowie, D, Badner, N, Herrick, I, Smith, H, Heard, G, Peterson, R, Howell, J, Lindsey, L, Carriere, L, von Lewinski, M, Schaefer, B, Bisnaire, D, Doyle-Pettypiece, P, McTaggart, M, Gelb, A, Young, W, Giannotta, S, Zelman, V, Thomson, E, Babayan, E, McCleary, C, Fishback, D, Samra, S, Thompson, B, Chandler, W, Mcgillicuddy, J, Tremper, K, Turner, C, Smythe, P, Dy, E, Pai, S, Portman, V, Palmisano, J, Auer, D, Quigley, M, Giordani, B, Freymuth, A, Scott, P, Silbergleit, R, Hickenbottom, S, Litt, L, Lawton, M, Hannegan, L, Gupta, D, Bickler, P, Dodson, B, Talke, P, Rampil, I, Chen, B, Wright, P, Mitchell, J, Ryan, S, Walker, J, Quinnine, N, Applebury, C, Myles, P, Rosenfeld, J, Hunt, J, Wallace, S, D'Urso, P, Thien, C, McMahon, J, Wadanamby, S, Siu, K, Malham, G, Laidlaw, J, Salerno, S, Alatakis, S, Madder, H, Cairo, S, Konstantatos, A, Smart, J, Lindholm, D, Bain, D, Machlin, H, Moloney, J, Buckland, M, Silvers, A, Downey, G, Molnar, A, Langley, M, McIlroy, D, Daly, D, Bennett, P, Forlano, L, Testa, R, Burnett, W, Johnson, F, Angliss, M, Fletcher, H, Manninen, P, Wallace, M, Lukitto, K, Tymianski, M, Porter, P, Gentili, F, El-Beheiry, H, Mosa, M, Mak, P, Balki, M, Shaikh, S, Sawyer, R, Quader, K, Chelliah, R, Berklayd, P, Merah, N, Ghazali, G, McAndrews, M, Ridgley, J, Odukoya, O, Yantha, S, Wilson, J, Petrozza, P, Miller, C, O'Brien, K, Tong, C, Olympio, M, Reynolds, J, Colonna, D, Glazier, S, Nobles, S, Hill, D, Hulbert, H, Jenkins, W, Piepgras, D, Wilson, R, Meyer, F, Atkinson, J, Link, M, Weglinski, M, Berge, K, Trenerry, M, Smith, G, Walkes, J, Felmlee-Devine, M, Van Aken, H, Greiner, C, Freise, H, Brors, H, Hahnenkamp, K, Monteirode Oliveira, N, Schul, C, Moskopp, D, Woelfer, J, Hoenemann, C, Gramke, H, Bone, H, Gibmeier, I, Wirtz, S, Lohmann, H, Freyhoff, J, Bauer, B, Hogan, K, Dempsey, R, Badie, B, Iskandar, B, Resnick, D, Deshmukh, P, Fitzpatrick, J, Sasse, F, Broderick, T, Willmann, K, Connery, L, Kish, J, Weasler, C, Page, N, Hermann, B, Jones, J, Dulli, D, Stanko, H, Geraghty, M, Elbe, R, Salevsky, F, Leblanc, R, Lapointe, N, MacGregor, H, Sinclair, D, Sirhan, D, Maleki, M, Abou-Madi, M, Chartrand, D, Angle, M, Milovan, D, Painchaud, Y, Mirski, M, Tamargo, R, Rice, S, Olivi, A, Kim, D, Rigamonti, D, Naff, N, Hemstreet, M, Berkow, L, Chery, P, Ulatowski, J, Moore, L, Cunningham, T, McBee, N, Hartman, T, Heidler, J, Hillis, A, Tuffiash, E, Chase, C, Kane, A, Greene-Chandos, D, Torbey, M, Ziai, W, Lane, K, Bhardwaj, A, Subhas, N, Schubert, A, Mayberg, M, Beven, M, Rasmussen, P, Woo, H, Bhatia, S, Ebrahim, Z, Lotto, M, Vasarhelyi, F, Munis, J, Graves, K, Woletz, J, Chelune, G, Samples, S, Evans, J, Blair, D, Abou-Chebl, A, Shutway, F, Manke, D, Beven, C, Fogarty-Mack, P, Stieg, P, Eliazo, R, Li, P, Riina, H, Lien, C, Ravdin, L, Wang, J, Kuo, Y, Jaffe, R, Steinberg, G, Luu, D, Chang, S, Giffard, R, Lemmens, H, Morgan, R, Mathur, A, Angst, M, Meyer, A, Yi, H, Karzmark, P, Bell-Stephens, T, Marcellus, M, Sneyd, J, Pobereskin, L, Salsbury, S, Whitfield, P, Sawyer, R, Dashfield, A, Struthers, R, Davies, P, Rushton, A, Petty, V, Harding, S, Richardson, E, Yonas, H, Gyulai, F, Kirby, L, Kassam, A, Bircher, N, Meng, L, Krugh, J, Seever, G, Hendrickson, R, Gebel, J, Cowie, D, Fabinyi, G, Poustie, S, Davis, G, Drnda, A, Chandrasekara, D, Sturm, J, Phan, T, Shelton, A, Clausen, M, Micallef, S, Sills, A, Steinman, F, Sutton, P, Sanders, J, Van Alstine, D, Leggett, D, Cunningham, E, Hamm, W, Frankel, B, Sorenson, J, Atkins, L, Redmond, A, Dalrymple, S, Black, S, Fisher, W, Hall, C, Wilhite, D, Moore, T, Blanton, P, Sha, Z, Szmuk, P, Kim, D, Ashtari, A, Hagberg, C, Matuszczak, M, Shahen, A, Moise, O, Novy, D, Govindaraj, R, Jameson, L, Breeze, R, Awad, I, Mattison, R, Anderson, T, Salvia, L, Mosier, M, Loftus, C, Smith, J, Lilley, W, White, B, Lenaerts, M & Loftus, C 2009, 'Effect of nitrous oxide use on long-term neurologic and neuropsychological outcome in patients who received temporary proximal artery occlusion during cerebral aneurysm clipping surgery', Anesthesiology, vol. 110, no. 3, pp. 563-573. https://doi.org/10.1097/ALN.0b013e318197ff81
Pasternak, Jeffrey J. ; McGregor, Diana G. ; Lanier, William L. ; Schroeder, Darrell R. ; Rusy, Deborah A. ; Hindman, Bradley ; Clarke, William ; Torner, James ; Todd, Michael M. ; Chaloner, K. ; Davis, P. ; Tranel, D. ; Winn, J. ; Wichman, M. ; Peters, R. ; Hansen, M. ; Anderson, D. ; Lang, J. ; Yoo, B. ; Adams, H. ; Clifton, G. ; Warner, D. ; Frankowski, R. ; Kieburtz, K. ; Prough, Donald ; Sternau, L. ; Marler, J. ; Moy, C. ; Radziszewska, B. ; Matta, B. ; Kirkpatrick, P. ; Chatfield, D. ; Skilbeck, C. ; Kirollos, R. ; Rasulo, F. ; English, K. ; Duffy, C. ; Pedersen, K. ; Scurrah, N. ; Burnstein, R. ; Prabhu, A. ; Salmond, C. ; Blackwell, A. ; Birrell, J. ; Jackson, S. ; Kassell, N. ; Pajewski, T. ; Fraley, H. ; Morris, A. ; Alden, T. ; Shaffrey, M. ; Bogdonoff, D. ; Durieux, M. ; Zuo, Z. ; Littlewood, K. ; Nemergut, E. ; Bedford, R. ; Stone, D. ; Balestrieri, P. ; Mason, J. ; Henry, G. ; Ting, P. ; Shafer, J. ; Blount, T. ; Kim, L. ; James, A. ; Farace, E. ; Clark, L. ; Irons, M. ; Sasaki, T. ; Webb, K. ; Short, T. ; Mee, E. ; Ormrod, J. ; Jane, J. ; Alden, T. ; Heppner, P. ; Olson, S. ; Ellegala, D. ; Lind, C. ; Sheehan, J. ; Woodfield, M. ; Law, A. ; Harrison, M. ; Davies, P. ; Campbell, D. ; Robertson, N. ; Fry, R. ; Sage, D. ; Laurent, S. ; Bradfield, C. ; Pedersen, K. ; Smith, K. ; Young, Y. ; Chambers, C. ; Hodkinson, B. ; Biddulph, J. ; Jensen, L. ; Ogden, J. ; Thayer, Z. ; Lee, F. ; Crump, S. ; Quaedackers, J. ; Wray, A. ; Roelfsema, V. ; Greif, R. ; Kleinpeter, G. ; Lothaller, C. ; Knosp, E. ; Pfisterer, W. ; Schatzer, R. ; Salem, C. ; Kutalek, W. ; Tuerkkan, E. ; Koller, L. ; Weber, T. ; Buchmann, A. ; Merhaut, C. ; Graf, M. ; Rapf, B. ; Lam, A. ; Newell, D. ; Tanzi, P. ; Lee, L. ; Domino, K. ; Vavilala, M. ; Bramhall, J. ; Souter, M. ; Britz, G. ; Winn, H. ; Bybee, H. ; Costello, T. ; Murphy, M. ; Harris, K. ; Thien, C. ; Nye, D. ; Han, T. ; McNeill, P. ; O'Brien, B. ; Cormack, J. ; Wyss, A. ; Grauer, R. ; Popovic, R. ; Jones, S. ; Deam, R. ; Heard, G. ; Watson, R. ; Evered, L. ; Bardenhagen, F. ; Meade, C. ; Haartsen, J. ; Kruger, J. ; Wilson, M. ; Maktabi, M. ; Traynelis, V. ; McAllister, A. ; Leonard, P. ; Hindman, B. ; Brian, J. ; Mensink, F. ; From, R. ; Papworth, D. ; Schmid, P. ; Dehring, D. ; Howard, M. ; Hitchon, P. ; VanGilder, J. ; Weeks, J. ; Moss, L. ; Manzel, K. ; Anderson, S. ; Tack, R. ; Taggard, D. ; Lennarson, P. ; Menhusen, M. ; Gelb, A. ; Lownie, S. ; Craen, R. ; Novick, T. ; Ferguson, G. ; Duggal, N. ; Findlay, J. ; Ng, W. ; Cowie, D. ; Badner, N. ; Herrick, I. ; Smith, H. ; Heard, G. ; Peterson, R. ; Howell, J. ; Lindsey, L. ; Carriere, L. ; von Lewinski, M. ; Schaefer, B. ; Bisnaire, D. ; Doyle-Pettypiece, P. ; McTaggart, M. ; Gelb, A. ; Young, W. ; Giannotta, S. ; Zelman, V. ; Thomson, E. ; Babayan, E. ; McCleary, C. ; Fishback, D. ; Samra, S. ; Thompson, B. ; Chandler, W. ; Mcgillicuddy, J. ; Tremper, K. ; Turner, C. ; Smythe, P. ; Dy, E. ; Pai, S. ; Portman, V. ; Palmisano, J. ; Auer, D. ; Quigley, M. ; Giordani, B. ; Freymuth, A. ; Scott, P. ; Silbergleit, R. ; Hickenbottom, S. ; Litt, L. ; Lawton, M. ; Hannegan, L. ; Gupta, D. ; Bickler, P. ; Dodson, B. ; Talke, P. ; Rampil, I. ; Chen, B. ; Wright, P. ; Mitchell, J. ; Ryan, S. ; Walker, J. ; Quinnine, N. ; Applebury, C. ; Myles, P. ; Rosenfeld, J. ; Hunt, J. ; Wallace, S. ; D'Urso, P. ; Thien, C. ; McMahon, J. ; Wadanamby, S. ; Siu, K. ; Malham, G. ; Laidlaw, J. ; Salerno, S. ; Alatakis, S. ; Madder, H. ; Cairo, S. ; Konstantatos, A. ; Smart, J. ; Lindholm, D. ; Bain, D. ; Machlin, H. ; Moloney, J. ; Buckland, M. ; Silvers, A. ; Downey, G. ; Molnar, A. ; Langley, M. ; McIlroy, D. ; Daly, D. ; Bennett, P. ; Forlano, L. ; Testa, R. ; Burnett, W. ; Johnson, F. ; Angliss, M. ; Fletcher, H. ; Manninen, P. ; Wallace, M. ; Lukitto, K. ; Tymianski, M. ; Porter, P. ; Gentili, F. ; El-Beheiry, H. ; Mosa, M. ; Mak, P. ; Balki, M. ; Shaikh, S. ; Sawyer, R. ; Quader, K. ; Chelliah, R. ; Berklayd, P. ; Merah, N. ; Ghazali, G. ; McAndrews, M. ; Ridgley, J. ; Odukoya, O. ; Yantha, S. ; Wilson, J. ; Petrozza, P. ; Miller, C. ; O'Brien, K. ; Tong, C. ; Olympio, M. ; Reynolds, J. ; Colonna, D. ; Glazier, S. ; Nobles, S. ; Hill, D. ; Hulbert, H. ; Jenkins, W. ; Piepgras, D. ; Wilson, R. ; Meyer, F. ; Atkinson, J. ; Link, M. ; Weglinski, M. ; Berge, K. ; Trenerry, M. ; Smith, G. ; Walkes, J. ; Felmlee-Devine, M. ; Van Aken, H. ; Greiner, C. ; Freise, H. ; Brors, H. ; Hahnenkamp, K. ; Monteirode Oliveira, N. ; Schul, C. ; Moskopp, D. ; Woelfer, J. ; Hoenemann, C. ; Gramke, H. ; Bone, H. ; Gibmeier, I. ; Wirtz, S. ; Lohmann, H. ; Freyhoff, J. ; Bauer, B. ; Hogan, K. ; Dempsey, R. ; Badie, B. ; Iskandar, B. ; Resnick, D. ; Deshmukh, P. ; Fitzpatrick, J. ; Sasse, F. ; Broderick, T. ; Willmann, K. ; Connery, L. ; Kish, J. ; Weasler, C. ; Page, N. ; Hermann, B. ; Jones, J. ; Dulli, D. ; Stanko, H. ; Geraghty, M. ; Elbe, R. ; Salevsky, F. ; Leblanc, R. ; Lapointe, N. ; MacGregor, H. ; Sinclair, D. ; Sirhan, D. ; Maleki, M. ; Abou-Madi, M. ; Chartrand, D. ; Angle, M. ; Milovan, D. ; Painchaud, Y. ; Mirski, M. ; Tamargo, R. ; Rice, S. ; Olivi, A. ; Kim, D. ; Rigamonti, D. ; Naff, N. ; Hemstreet, M. ; Berkow, L. ; Chery, P. ; Ulatowski, J. ; Moore, L. ; Cunningham, T. ; McBee, N. ; Hartman, T. ; Heidler, J. ; Hillis, A. ; Tuffiash, E. ; Chase, C. ; Kane, A. ; Greene-Chandos, D. ; Torbey, M. ; Ziai, W. ; Lane, K. ; Bhardwaj, Anish ; Subhas, N. ; Schubert, A. ; Mayberg, M. ; Beven, M. ; Rasmussen, P. ; Woo, H. ; Bhatia, S. ; Ebrahim, Z. ; Lotto, M. ; Vasarhelyi, F. ; Munis, J. ; Graves, K. ; Woletz, J. ; Chelune, G. ; Samples, S. ; Evans, J. ; Blair, D. ; Abou-Chebl, A. ; Shutway, F. ; Manke, D. ; Beven, C. ; Fogarty-Mack, P. ; Stieg, P. ; Eliazo, R. ; Li, P. ; Riina, H. ; Lien, C. ; Ravdin, L. ; Wang, J. ; Kuo, Y. ; Jaffe, R. ; Steinberg, G. ; Luu, D. ; Chang, S. ; Giffard, R. ; Lemmens, H. ; Morgan, R. ; Mathur, A. ; Angst, M. ; Meyer, A. ; Yi, H. ; Karzmark, P. ; Bell-Stephens, T. ; Marcellus, M. ; Sneyd, J. ; Pobereskin, L. ; Salsbury, S. ; Whitfield, P. ; Sawyer, R. ; Dashfield, A. ; Struthers, R. ; Davies, P. ; Rushton, A. ; Petty, V. ; Harding, S. ; Richardson, E. ; Yonas, H. ; Gyulai, F. ; Kirby, L. ; Kassam, A. ; Bircher, N. ; Meng, L. ; Krugh, J. ; Seever, G. ; Hendrickson, R. ; Gebel, J. ; Cowie, D. ; Fabinyi, G. ; Poustie, S. ; Davis, G. ; Drnda, A. ; Chandrasekara, D. ; Sturm, J. ; Phan, T. ; Shelton, A. ; Clausen, M. ; Micallef, S. ; Sills, A. ; Steinman, F. ; Sutton, P. ; Sanders, J. ; Van Alstine, D. ; Leggett, D. ; Cunningham, E. ; Hamm, W. ; Frankel, B. ; Sorenson, J. ; Atkins, L. ; Redmond, A. ; Dalrymple, S. ; Black, S. ; Fisher, W. ; Hall, C. ; Wilhite, D. ; Moore, T. ; Blanton, P. ; Sha, Z. ; Szmuk, P. ; Kim, D. ; Ashtari, A. ; Hagberg, C. ; Matuszczak, M. ; Shahen, A. ; Moise, O. ; Novy, D. ; Govindaraj, R. ; Jameson, L. ; Breeze, R. ; Awad, I. ; Mattison, R. ; Anderson, T. ; Salvia, L. ; Mosier, M. ; Loftus, C. ; Smith, J. ; Lilley, W. ; White, B. ; Lenaerts, M. ; Loftus, C. / Effect of nitrous oxide use on long-term neurologic and neuropsychological outcome in patients who received temporary proximal artery occlusion during cerebral aneurysm clipping surgery. In: Anesthesiology. 2009 ; Vol. 110, No. 3. pp. 563-573.
@article{c3b0ce32d5944d09bedf36f812f789ef,
title = "Effect of nitrous oxide use on long-term neurologic and neuropsychological outcome in patients who received temporary proximal artery occlusion during cerebral aneurysm clipping surgery",
abstract = "BACKGROUND: The authors explored the relationship between nitrous oxide use and neurologic and neuropsychological outcome in a population of patients likely to experience intraoperative cerebral ischemia: those who had temporary cerebral arterial occlusion during aneurysm clipping surgery. METHODS: A post hoc analysis of a subset of the data from the Intraoperative Hypothermia for Aneurysm Surgery Trial was conducted. Only subjects who had temporary arterial occlusion during surgery were included in the analysis. Metrics of short-term and long-term (i.e., 3 months after surgery) outcome were evaluated via both univariate and multivariate logistic regression analysis. An odds ratio (OR) greater than 1.0 denotes a worse outcome in patients receiving nitrous oxide. RESULTS: The authors evaluated 441 patients, of which 199 received nitrous oxide. Patients receiving nitrous oxide had a greater risk of delayed ischemic neurologic deficits (i.e., the clinical manifestation of vasospasm) (OR, 1.78, 95{\%} confidence interval [CI], 1.08-2.95; P = 0.025). However, at 3 months after surgery, there was no difference in any metric of gross neurologic outcome: Glasgow Outcome Score (OR, 0.67; CI, 0.44-1.03; P = 0.065), Rankin Score (OR, 0.74; CI, 0.47-1.16; P = 0.192), National Institutes of Health Stroke Scale (OR, 1.02; CI, 0.66-1.56; P = 0.937), or Barthel Index (OR, 0.69; CI, 0.38-1.25; P = 0.22). The risk of impairment on at least one test of neuropsychological function was reduced in those who received nitrous oxide (OR, 0.56; CI, 0.36-0.89; P = 0.013). CONCLUSION: In this patient population, use of nitrous oxide was associated with an increased risk for the development of delayed ischemic neurologic deficits; however, there was no evidence of detriment to long-term gross neurologic or neuropsychological outcome.",
author = "Pasternak, {Jeffrey J.} and McGregor, {Diana G.} and Lanier, {William L.} and Schroeder, {Darrell R.} and Rusy, {Deborah A.} and Bradley Hindman and William Clarke and James Torner and Todd, {Michael M.} and K. Chaloner and P. Davis and D. Tranel and J. Winn and M. Wichman and R. Peters and M. Hansen and D. Anderson and J. Lang and B. Yoo and H. Adams and G. Clifton and D. Warner and R. Frankowski and K. Kieburtz and Donald Prough and L. Sternau and J. Marler and C. Moy and B. Radziszewska and B. Matta and P. Kirkpatrick and D. Chatfield and C. Skilbeck and R. Kirollos and F. Rasulo and K. English and C. Duffy and K. Pedersen and N. Scurrah and R. Burnstein and A. Prabhu and C. Salmond and A. Blackwell and J. Birrell and S. Jackson and N. Kassell and T. Pajewski and H. Fraley and A. Morris and T. Alden and M. Shaffrey and D. Bogdonoff and M. Durieux and Z. Zuo and K. Littlewood and E. Nemergut and R. Bedford and D. Stone and P. Balestrieri and J. Mason and G. Henry and P. Ting and J. Shafer and T. Blount and L. Kim and A. James and E. Farace and L. Clark and M. Irons and T. Sasaki and K. Webb and T. Short and E. Mee and J. Ormrod and J. Jane and T. Alden and P. Heppner and S. Olson and D. Ellegala and C. Lind and J. Sheehan and M. Woodfield and A. Law and M. Harrison and P. Davies and D. Campbell and N. Robertson and R. Fry and D. Sage and S. Laurent and C. Bradfield and K. Pedersen and K. Smith and Y. Young and C. Chambers and B. Hodkinson and J. Biddulph and L. Jensen and J. Ogden and Z. Thayer and F. Lee and S. Crump and J. Quaedackers and A. Wray and V. Roelfsema and R. Greif and G. Kleinpeter and C. Lothaller and E. Knosp and W. Pfisterer and R. Schatzer and C. Salem and W. Kutalek and E. Tuerkkan and L. Koller and T. Weber and A. Buchmann and C. Merhaut and M. Graf and B. Rapf and A. Lam and D. Newell and P. Tanzi and L. Lee and K. Domino and M. Vavilala and J. Bramhall and M. Souter and G. Britz and H. Winn and H. Bybee and T. Costello and M. Murphy and K. Harris and C. Thien and D. Nye and T. Han and P. McNeill and B. O'Brien and J. Cormack and A. Wyss and R. Grauer and R. Popovic and S. Jones and R. Deam and G. Heard and R. Watson and L. Evered and F. Bardenhagen and C. Meade and J. Haartsen and J. Kruger and M. Wilson and M. Maktabi and V. Traynelis and A. McAllister and P. Leonard and B. Hindman and J. Brian and F. Mensink and R. From and D. Papworth and P. Schmid and D. Dehring and M. Howard and P. Hitchon and J. VanGilder and J. Weeks and L. Moss and K. Manzel and S. Anderson and R. Tack and D. Taggard and P. Lennarson and M. Menhusen and A. Gelb and S. Lownie and R. Craen and T. Novick and G. Ferguson and N. Duggal and J. Findlay and W. Ng and D. Cowie and N. Badner and I. Herrick and H. Smith and G. Heard and R. Peterson and J. Howell and L. Lindsey and L. Carriere and {von Lewinski}, M. and B. Schaefer and D. Bisnaire and P. Doyle-Pettypiece and M. McTaggart and A. Gelb and W. Young and S. Giannotta and V. Zelman and E. Thomson and E. Babayan and C. McCleary and D. Fishback and S. Samra and B. Thompson and W. Chandler and J. Mcgillicuddy and K. Tremper and C. Turner and P. Smythe and E. Dy and S. Pai and V. Portman and J. Palmisano and D. Auer and M. Quigley and B. Giordani and A. Freymuth and P. Scott and R. Silbergleit and S. Hickenbottom and L. Litt and M. Lawton and L. Hannegan and D. Gupta and P. Bickler and B. Dodson and P. Talke and I. Rampil and B. Chen and P. Wright and J. Mitchell and S. Ryan and J. Walker and N. Quinnine and C. Applebury and P. Myles and J. Rosenfeld and J. Hunt and S. Wallace and P. D'Urso and C. Thien and J. McMahon and S. Wadanamby and K. Siu and G. Malham and J. Laidlaw and S. Salerno and S. Alatakis and H. Madder and S. Cairo and A. Konstantatos and J. Smart and D. Lindholm and D. Bain and H. Machlin and J. Moloney and M. Buckland and A. Silvers and G. Downey and A. Molnar and M. Langley and D. McIlroy and D. Daly and P. Bennett and L. Forlano and R. Testa and W. Burnett and F. Johnson and M. Angliss and H. Fletcher and P. Manninen and M. Wallace and K. Lukitto and M. Tymianski and P. Porter and F. Gentili and H. El-Beheiry and M. Mosa and P. Mak and M. Balki and S. Shaikh and R. Sawyer and K. Quader and R. Chelliah and P. Berklayd and N. Merah and G. Ghazali and M. McAndrews and J. Ridgley and O. Odukoya and S. Yantha and J. Wilson and P. Petrozza and C. Miller and K. O'Brien and C. Tong and M. Olympio and J. Reynolds and D. Colonna and S. Glazier and S. Nobles and D. Hill and H. Hulbert and W. Jenkins and D. Piepgras and R. Wilson and F. Meyer and J. Atkinson and M. Link and M. Weglinski and K. Berge and M. Trenerry and G. Smith and J. Walkes and M. Felmlee-Devine and {Van Aken}, H. and C. Greiner and H. Freise and H. Brors and K. Hahnenkamp and {Monteirode Oliveira}, N. and C. Schul and D. Moskopp and J. Woelfer and C. Hoenemann and H. Gramke and H. Bone and I. Gibmeier and S. Wirtz and H. Lohmann and J. Freyhoff and B. Bauer and K. Hogan and R. Dempsey and B. Badie and B. Iskandar and D. Resnick and P. Deshmukh and J. Fitzpatrick and F. Sasse and T. Broderick and K. Willmann and L. Connery and J. Kish and C. Weasler and N. Page and B. Hermann and J. Jones and D. Dulli and H. Stanko and M. Geraghty and R. Elbe and F. Salevsky and R. Leblanc and N. Lapointe and H. MacGregor and D. Sinclair and D. Sirhan and M. Maleki and M. Abou-Madi and D. Chartrand and M. Angle and D. Milovan and Y. Painchaud and M. Mirski and R. Tamargo and S. Rice and A. Olivi and D. Kim and D. Rigamonti and N. Naff and M. Hemstreet and L. Berkow and P. Chery and J. Ulatowski and L. Moore and T. Cunningham and N. McBee and T. Hartman and J. Heidler and A. Hillis and E. Tuffiash and C. Chase and A. Kane and D. Greene-Chandos and M. Torbey and W. Ziai and K. Lane and Anish Bhardwaj and N. Subhas and A. Schubert and M. Mayberg and M. Beven and P. Rasmussen and H. Woo and S. Bhatia and Z. Ebrahim and M. Lotto and F. Vasarhelyi and J. Munis and K. Graves and J. Woletz and G. Chelune and S. Samples and J. Evans and D. Blair and A. Abou-Chebl and F. Shutway and D. Manke and C. Beven and P. Fogarty-Mack and P. Stieg and R. Eliazo and P. Li and H. Riina and C. Lien and L. Ravdin and J. Wang and Y. Kuo and R. Jaffe and G. Steinberg and D. Luu and S. Chang and R. Giffard and H. Lemmens and R. Morgan and A. Mathur and M. Angst and A. Meyer and H. Yi and P. Karzmark and T. Bell-Stephens and M. Marcellus and J. Sneyd and L. Pobereskin and S. Salsbury and P. Whitfield and R. Sawyer and A. Dashfield and R. Struthers and P. Davies and A. Rushton and V. Petty and S. Harding and E. Richardson and H. Yonas and F. Gyulai and L. Kirby and A. Kassam and N. Bircher and L. Meng and J. Krugh and G. Seever and R. Hendrickson and J. Gebel and D. Cowie and G. Fabinyi and S. Poustie and G. Davis and A. Drnda and D. Chandrasekara and J. Sturm and T. Phan and A. Shelton and M. Clausen and S. Micallef and A. Sills and F. Steinman and P. Sutton and J. Sanders and {Van Alstine}, D. and D. Leggett and E. Cunningham and W. Hamm and B. Frankel and J. Sorenson and L. Atkins and A. Redmond and S. Dalrymple and S. Black and W. Fisher and C. Hall and D. Wilhite and T. Moore and P. Blanton and Z. Sha and P. Szmuk and D. Kim and A. Ashtari and C. Hagberg and M. Matuszczak and A. Shahen and O. Moise and D. Novy and R. Govindaraj and L. Jameson and R. Breeze and I. Awad and R. Mattison and T. Anderson and L. Salvia and M. Mosier and C. Loftus and J. Smith and W. Lilley and B. White and M. Lenaerts and C. Loftus",
year = "2009",
month = "3",
doi = "10.1097/ALN.0b013e318197ff81",
language = "English (US)",
volume = "110",
pages = "563--573",
journal = "Anesthesiology",
issn = "0003-3022",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Effect of nitrous oxide use on long-term neurologic and neuropsychological outcome in patients who received temporary proximal artery occlusion during cerebral aneurysm clipping surgery

AU - Pasternak, Jeffrey J.

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AU - Painchaud, Y.

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AU - Rice, S.

AU - Olivi, A.

AU - Kim, D.

AU - Rigamonti, D.

AU - Naff, N.

AU - Hemstreet, M.

AU - Berkow, L.

AU - Chery, P.

AU - Ulatowski, J.

AU - Moore, L.

AU - Cunningham, T.

AU - McBee, N.

AU - Hartman, T.

AU - Heidler, J.

AU - Hillis, A.

AU - Tuffiash, E.

AU - Chase, C.

AU - Kane, A.

AU - Greene-Chandos, D.

AU - Torbey, M.

AU - Ziai, W.

AU - Lane, K.

AU - Bhardwaj, Anish

AU - Subhas, N.

AU - Schubert, A.

AU - Mayberg, M.

AU - Beven, M.

AU - Rasmussen, P.

AU - Woo, H.

AU - Bhatia, S.

AU - Ebrahim, Z.

AU - Lotto, M.

AU - Vasarhelyi, F.

AU - Munis, J.

AU - Graves, K.

AU - Woletz, J.

AU - Chelune, G.

AU - Samples, S.

AU - Evans, J.

AU - Blair, D.

AU - Abou-Chebl, A.

AU - Shutway, F.

AU - Manke, D.

AU - Beven, C.

AU - Fogarty-Mack, P.

AU - Stieg, P.

AU - Eliazo, R.

AU - Li, P.

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AU - Morgan, R.

AU - Mathur, A.

AU - Angst, M.

AU - Meyer, A.

AU - Yi, H.

AU - Karzmark, P.

AU - Bell-Stephens, T.

AU - Marcellus, M.

AU - Sneyd, J.

AU - Pobereskin, L.

AU - Salsbury, S.

AU - Whitfield, P.

AU - Sawyer, R.

AU - Dashfield, A.

AU - Struthers, R.

AU - Davies, P.

AU - Rushton, A.

AU - Petty, V.

AU - Harding, S.

AU - Richardson, E.

AU - Yonas, H.

AU - Gyulai, F.

AU - Kirby, L.

AU - Kassam, A.

AU - Bircher, N.

AU - Meng, L.

AU - Krugh, J.

AU - Seever, G.

AU - Hendrickson, R.

AU - Gebel, J.

AU - Cowie, D.

AU - Fabinyi, G.

AU - Poustie, S.

AU - Davis, G.

AU - Drnda, A.

AU - Chandrasekara, D.

AU - Sturm, J.

AU - Phan, T.

AU - Shelton, A.

AU - Clausen, M.

AU - Micallef, S.

AU - Sills, A.

AU - Steinman, F.

AU - Sutton, P.

AU - Sanders, J.

AU - Van Alstine, D.

AU - Leggett, D.

AU - Cunningham, E.

AU - Hamm, W.

AU - Frankel, B.

AU - Sorenson, J.

AU - Atkins, L.

AU - Redmond, A.

AU - Dalrymple, S.

AU - Black, S.

AU - Fisher, W.

AU - Hall, C.

AU - Wilhite, D.

AU - Moore, T.

AU - Blanton, P.

AU - Sha, Z.

AU - Szmuk, P.

AU - Kim, D.

AU - Ashtari, A.

AU - Hagberg, C.

AU - Matuszczak, M.

AU - Shahen, A.

AU - Moise, O.

AU - Novy, D.

AU - Govindaraj, R.

AU - Jameson, L.

AU - Breeze, R.

AU - Awad, I.

AU - Mattison, R.

AU - Anderson, T.

AU - Salvia, L.

AU - Mosier, M.

AU - Loftus, C.

AU - Smith, J.

AU - Lilley, W.

AU - White, B.

AU - Lenaerts, M.

AU - Loftus, C.

PY - 2009/3

Y1 - 2009/3

N2 - BACKGROUND: The authors explored the relationship between nitrous oxide use and neurologic and neuropsychological outcome in a population of patients likely to experience intraoperative cerebral ischemia: those who had temporary cerebral arterial occlusion during aneurysm clipping surgery. METHODS: A post hoc analysis of a subset of the data from the Intraoperative Hypothermia for Aneurysm Surgery Trial was conducted. Only subjects who had temporary arterial occlusion during surgery were included in the analysis. Metrics of short-term and long-term (i.e., 3 months after surgery) outcome were evaluated via both univariate and multivariate logistic regression analysis. An odds ratio (OR) greater than 1.0 denotes a worse outcome in patients receiving nitrous oxide. RESULTS: The authors evaluated 441 patients, of which 199 received nitrous oxide. Patients receiving nitrous oxide had a greater risk of delayed ischemic neurologic deficits (i.e., the clinical manifestation of vasospasm) (OR, 1.78, 95% confidence interval [CI], 1.08-2.95; P = 0.025). However, at 3 months after surgery, there was no difference in any metric of gross neurologic outcome: Glasgow Outcome Score (OR, 0.67; CI, 0.44-1.03; P = 0.065), Rankin Score (OR, 0.74; CI, 0.47-1.16; P = 0.192), National Institutes of Health Stroke Scale (OR, 1.02; CI, 0.66-1.56; P = 0.937), or Barthel Index (OR, 0.69; CI, 0.38-1.25; P = 0.22). The risk of impairment on at least one test of neuropsychological function was reduced in those who received nitrous oxide (OR, 0.56; CI, 0.36-0.89; P = 0.013). CONCLUSION: In this patient population, use of nitrous oxide was associated with an increased risk for the development of delayed ischemic neurologic deficits; however, there was no evidence of detriment to long-term gross neurologic or neuropsychological outcome.

AB - BACKGROUND: The authors explored the relationship between nitrous oxide use and neurologic and neuropsychological outcome in a population of patients likely to experience intraoperative cerebral ischemia: those who had temporary cerebral arterial occlusion during aneurysm clipping surgery. METHODS: A post hoc analysis of a subset of the data from the Intraoperative Hypothermia for Aneurysm Surgery Trial was conducted. Only subjects who had temporary arterial occlusion during surgery were included in the analysis. Metrics of short-term and long-term (i.e., 3 months after surgery) outcome were evaluated via both univariate and multivariate logistic regression analysis. An odds ratio (OR) greater than 1.0 denotes a worse outcome in patients receiving nitrous oxide. RESULTS: The authors evaluated 441 patients, of which 199 received nitrous oxide. Patients receiving nitrous oxide had a greater risk of delayed ischemic neurologic deficits (i.e., the clinical manifestation of vasospasm) (OR, 1.78, 95% confidence interval [CI], 1.08-2.95; P = 0.025). However, at 3 months after surgery, there was no difference in any metric of gross neurologic outcome: Glasgow Outcome Score (OR, 0.67; CI, 0.44-1.03; P = 0.065), Rankin Score (OR, 0.74; CI, 0.47-1.16; P = 0.192), National Institutes of Health Stroke Scale (OR, 1.02; CI, 0.66-1.56; P = 0.937), or Barthel Index (OR, 0.69; CI, 0.38-1.25; P = 0.22). The risk of impairment on at least one test of neuropsychological function was reduced in those who received nitrous oxide (OR, 0.56; CI, 0.36-0.89; P = 0.013). CONCLUSION: In this patient population, use of nitrous oxide was associated with an increased risk for the development of delayed ischemic neurologic deficits; however, there was no evidence of detriment to long-term gross neurologic or neuropsychological outcome.

UR - http://www.scopus.com/inward/record.url?scp=62349116677&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=62349116677&partnerID=8YFLogxK

U2 - 10.1097/ALN.0b013e318197ff81

DO - 10.1097/ALN.0b013e318197ff81

M3 - Article

VL - 110

SP - 563

EP - 573

JO - Anesthesiology

JF - Anesthesiology

SN - 0003-3022

IS - 3

ER -