Article (Scientific journals)
Why We Still Use Intravenous Drugs as the Basic Regimen for Neurosurgical Anaesthesia
Hans, Pol; BONHOMME, Vincent
2006In Current Opinion in Anaesthesiology, 19 (5), p. 498-503
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Abstract :
[en] PURPOSE OF REVIEW: Evolution of neurosurgery mainly trends towards minimally invasive and functional procedures including endoscopies, small-size craniotomies, intraoperative imaging and stereotactic interventions. Consequently, new adjustments of anaesthesia should aim at providing brain relaxation, minimal interference with electrophysiological monitoring, rapid recovery, patients' cooperation during surgery and neuroprotection. RECENT FINDINGS: In brain tumour patients undergoing craniotomy, propofol anaesthesia is associated with lower intracranial pressure and cerebral swelling than volatile anaesthesia. Hyperventilation used to improve brain relaxation may decrease jugular venous oxygen saturation below the critical threshold. It decreases the cerebral perfusion pressure in patients receiving sevoflurane, but not in those receiving propofol. The advantage of propofol over volatile agents has also been confirmed regarding interference with somatosensory, auditory and motor evoked potentials. Excellent and predictable recovery conditions as well as minimal postoperative side-effects make propofol particularly suitable in awake craniotomies. Finally, the potential neuroprotective effect of this drug could be mediated by its antioxidant properties which can play a role in apoptosis, ischaemia-reperfusion injury and inflammatory-induced neuronal damage. SUMMARY: Although all the objectives of neurosurgical anaesthesia cannot be met by one single anaesthetic agent or technique, propofol-based intravenous anaesthesia appears as the first choice to challenge the evolution of neurosurgery in the third millennium.
Disciplines :
Anesthesia & intensive care
Author, co-author :
Hans, Pol ;  Université de Liège - ULiège > Département des sciences cliniques > Anesthésie et réanimation
BONHOMME, Vincent  ;  Centre Hospitalier Universitaire de Liège - CHU > Anesthésie et réanimation
Language :
English
Title :
Why We Still Use Intravenous Drugs as the Basic Regimen for Neurosurgical Anaesthesia
Publication date :
October 2006
Journal title :
Current Opinion in Anaesthesiology
ISSN :
0952-7907
eISSN :
1473-6500
Publisher :
Lippincott Williams & Wilkins, Philadelphia, United States - Pennsylvania
Volume :
19
Issue :
5
Pages :
498-503
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 13 August 2015

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