{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T19:42:49Z","timestamp":1789760569737,"version":"4.0.1"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2008,7]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>Stable hemodynamics, normocapnia, and adequate pain relief are considered important factors in the reduction of neurological complications in pediatric patients undergoing encephaloduroarteriomyosynangiosis (EDAMS) operations for the treatment of moyamoya disease. A preoperative skull block may reduce hemodynamic fluctuations and hypo- or hyperventilation due to emergence delirium or oversedation and provide adequate pain relief, thereby reducing postoperative morbidity.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Pediatric patients (age 3\u201313 years) undergoing EDAMS surgery for moyamoya disease were randomly divided into a nerve block (NB) group (18 cases) or control group (21 cases). The treatment group patients received a preoperative NB (0.25% 5\u20138 ml bupivacaine mixed with 20\u201340 mg methylprednisolone) targeting the supraorbital, supratrochlear, auriculotemporal, and posterior auricular nerves. Patients in the control group did not receive NB. General anesthesia with sevoflurane was induced in both groups.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>In the NB group, stable hemodynamic parameters were obtained with a lower sevoflurane concentration than in the control group. For delirious awakening, the odds ratio in the control group was 4.9 compared with the NB group. Pain and analgesic requirement were higher in the control patients than in the NB-treated patients during the postanesthesia care unit stay. However, the arterial CO<jats:sub>2<\/jats:sub> tension in the postanesthesia care unit did not differ between the 2 groups. The odds ratio in the control group for the rate of morbidity (cerebral infarction and reversible ischemic neurological deficits) during the first 24 hours following the operation was 3.2 compared with the NB group.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The use of skull block during EDAMS surgery provided easy hemodynamic control, calm awakening, and better pain relief and may be related to the reduced postoperative morbidity.<\/jats:p><\/jats:sec>","DOI":"10.3171\/ped\/2008\/2\/7\/037","type":"journal-article","created":{"date-parts":[[2008,6,30]],"date-time":"2008-06-30T18:03:42Z","timestamp":1214849022000},"page":"37-41","source":"Crossref","is-referenced-by-count":21,"title":["Effect of preoperative skull block on pediatric moyamoya disease"],"prefix":"10.3171","volume":"2","author":[{"given":"Hyun Joo","family":"Ahn","sequence":"first","affiliation":[{"name":"Departments of Anesthesiology and Pain Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie Ae","family":"Kim","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and Pain Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong Jin","family":"Lee","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and Pain Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and Pain Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyung Jin","family":"Shin","sequence":"additional","affiliation":[{"name":"Neurosurgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ik Soo","family":"Chung","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and Pain Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Kyoung","family":"Kim","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and Pain Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mi Sook","family":"Gwak","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and Pain Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soo Joo","family":"Choi","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and Pain Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0020037","series-title":"Paediatr Anaesth","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1111\/j.1460-9592.2005.01576.x","article-title":"Moya-moya disease and anesthesia","volume":"15","author":"Baykan","year":"2005"},{"key":"b2-0020037","series-title":"Paediatr Anaesth","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1046\/j.1460-9592.2002.00868.x","article-title":"Emergence behavior in children: defining the incidence of excitement and agitation following anaesthesia","volume":"12","author":"Cole","year":"2002"},{"key":"b3-0020037","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"383","DOI":"10.3171\/jns.1993.78.3.0383","article-title":"The perioperative use of corticosteroids and bupivacaine in the management of lumbar disc disease","volume":"78","author":"Glasser","year":"1993"},{"key":"b4-0020037","series-title":"Childs Nerv Syst","first-page":"734","article-title":"How does angiogenesis develop in pediatric moyamoya disease after surgery? 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