Neurosurgical anaesthesiaAnaesthesia for neurosurgery

Neuroanaesthesia is an expanding speciality that requires a good understanding of neurophysiology as well as the pathophysiology of raised intracranial pressure. Neuroanaesthetists need to ensure neurosurgical patients maintain an adequate cerebral perfusion pressure intraoperatively, while providing optimum operating conditions. To achieve this, a balanced anaesthetic technique preventing hypertensive surges and optimizing cerebral venous drainage by careful patient positioning is important. Knowledge of the therapeutic options available to the anaesthetist for decreasing ICP intraoperatively is essential. As neurosurgery evolves, it provides neuroanaesthetists with new challenges including awake craniotomies, stereotactic neurosurgery and intraoperative MRI.