Neuroanesthesia Considerations in Modern Surgical Practice: Navigating the Intricacies of Neural Hemodynamics and Anesthetic Management
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Abstract
The field of neuroanesthesia has witnessed profound advancements in recent years, spurred by an evolving understanding of neural physiology and surgical techniques. This article delves into the intricate realm of neuroanesthesia, exploring the nuanced considerations that guide anesthetic management during neurosurgical procedures. From the delicate balance of cerebral perfusion pressure to the intricacies of maintaining an optimal intraoperative neurophysiological environment, this discourse addresses the evolving landscape of neuroanesthetic care. An emphasis is placed on the contemporary challenges faced by anesthesiologists in adapting to novel surgical interventions, such as intraoperative neuroimaging and neurophysiological monitoring. Through an exploration of the latest research and clinical practices, this article aims to provide a comprehensive overview of the multifaceted dimensions inherent in neuroanesthetic decision-making.
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References
I. Dengler BA, Karam O, Barthol CA, Chance A, Snider LE, Mundy CM, et al. Ketamine boluses are associated with a reduction in intracranial pressure and an increase in cerebral perfusion pressure: A retrospective observational study of patients with severe traumatic brain injury. Crit Care Res Pract. 2022;2022:3834165. doi:10.1155/2022/3834165.
II. Gregers MCT, Mikkelsen S, Lindvig KP, Brøchner AC. Ketamine as an anaesthetic for patients with acute brain injury: A systematic review. Neurocrit Care. 2020;33:273–82.
III. Rueda Carrillo L, Garcia KA, Yalcin N, Shah M. Ketamine and its emergence in the field of neurology. Cureus. 2022;14:e27389. doi:10.7759/cureus.27389.
IV. Von der Brelie C, Seifert M, Rot S, Tittel A, Sanft C, Meier U, et al. Sedation of patients with acute aneurysmal subarachnoid hemorrhage with ketamine is safe and might influence the occurrence of cerebral infarctions associated with delayed cerebral ischemia. World Neurosurg. 2017;97:374–82.
V. Telles JPM, Welling LC, Coelho ACSDS, Rabelo NN, Teixeira MJ, Figueiredo EG. Cortical spreading depolarization and ketamine:A short systematic review. Neurophysiol Clin. 2021;51:145–51.
VI. Alkhachroum A, Der-Nigoghossian CA, Mathews E, Massad N, Letchinger R, Doyle K, et al. Ketamine to treat super-refractory status epilepticus. Neurology. 2020;95:e2286–94.
VII. Fung ELW, Yam KM, Yau MLY. Ketamine use for super-refractory status epilepticus in children. Hong Kong Med J. 2020;26:549–550.
VIII. Mandal S, Sinha VK, Goyal N. Efficacy of ketamine therapy in the treatment of depression. Indian J Psychiatry. 2019;61:480–5.
IX. Godoy DA, Badenes R, Pelosi P, Robba C. Ketamine in acute phase of severe traumatic brain injury “an old drug for new uses?” Crit Care. 2021;25:19. doi:10.1186/s13054-020-03452-x.
X. Shlobin NA, Rosenow JM. Nonopioid postoperative pain management in neurosurgery. Neurosurg Clin N Am. 2022;33:261–73.
XI. Lee SH, Kwun BD, Kim JU, Choi JH, Ahn JS, Park W, et al. Adenosine-induced transient asystole during intracranial aneurysm surgery:Indications, dosing, efficacy, and risks. Acta Neurochir (Wien) 2015;157:1879–86.
XII. Wang X, Feletti A, Tanaka R, Yamada Y, Suyama D, Kawase T, et al. Adenosine-induced flow arrest to facilitate intracranial complex aneurysm clip ligation:Review of the literature. Asian J Neurosurg. 2018;13:539–45.