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Neuroanesthesia

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Neuroanesthesia

What is Neuroanesthesia?

In a Neuroanesthesia department, specialised procedures are performed to provide anaesthesia for neurosurgical and other related procedures.

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Here are some common procedures and practices

  • Comprehensive Evaluation - Detailed assessment of the patient's medical history, neurological status, and specific needs related to the neurosurgical procedure.
  • Anesthesia Planning - Developing an individualised anaesthesia plan considering the type of surgery, patient comorbidities, and anticipated duration of the procedure.

  • Induction of Anesthesia
    • Intravenous Anaesthetics - Administering medications (e.g., propofol, etomidate) to induce anaesthesia quickly and safely.
    • Inhalational Agents - Using agents like sevoflurane or desflurane for maintenance of anaesthesia.
  • Monitoring - Continuous monitoring of vital signs (heart rate, blood pressure, oxygen saturation) and neurological status throughout the procedure using advanced monitoring techniques, such as.
    • Neuromuscular Monitoring - Ensuring adequate muscle relaxation during surgery.
    • Bispectral Index (BIS) Monitoring - Assessing the depth of anaesthesia to prevent awareness and ensure adequate sedation.

  • Intracranial Pressure (ICP) Monitoring - Insertion of devices (e.g., ICP monitors) to continuously assess intracranial pressure during neurosurgical procedures.
  • Positioning - Careful positioning of the patient during surgery to minimise pressure on nerves and ensure optimal surgical access (e.g., sitting position for posterior fossa surgery).

  • Fluid Management - Administering fluids and electrolytes judiciously to maintain hemodynamic stability and avoid complications.
  • Blood Pressure Control - Using medications to manage blood pressure, particularly during craniotomy or when manipulating cerebral blood flow.

  • Emergence from Anesthesia - Carefully managing the patient’s emergence from anaesthesia, monitoring neurological status, and ensuring airway patency.
  • Postoperative Monitoring - Observing for complications related to anaesthesia and surgery in a recovery area or ICU, including potential neurological deficits.

  • Postoperative Analgesia - Providing multimodal pain management strategies to minimise discomfort, which may include regional anaesthesia techniques (e.g., epidural analgesia) or systemic analgesics.

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