Anesthesiology clinics
-
Stroke is a major cause of death and disability. Anesthesiologists are likely to encounter patients with stroke and must be aware of the anesthetic considerations for these patients. ⋯ The results of these studies have several limitations, and current evidence is inadequate to guide the choice of anesthesia in patients with acute stroke. The choice of anesthesia must be based on individual patient factors until further research is completed.
-
Airway management for neuroanesthesiology brings together some key principles that are shared throughout neuroanesthesiology. This article appropriately targets the cervical spine with associated injury and the challenges surrounding airway management. The primary focus of this article is on the unique airway management obstacles encountered with cervical spine injury or cervical spine surgery, and unique considerations regarding functional neurosurgery are addressed. Furthermore, topics related to difficult airway management for those with rheumatoid arthritis or pituitary surgery are reviewed.
-
Concerns for toxic effects of anesthesia to the brains of the young and the elderly are mounting. While experimental evidence for such effects in the developing brain is strong, the underlying mechanisms are less well understood and debate continues as to whether young humans are at risk for anesthetic neurotoxicity. ⋯ For both patient groups, today's evidence is not sufficient to guide change in clinical practice. Well-designed research is therefore imperative to tackle this critical issue.
-
Anesthesiology clinics · Jun 2012
ReviewOutcomes after neuroanesthesia and neurosurgery: what makes a difference.
Although there is a huge body of literature concerning the cerebrovascular and cerebrometabolic effects of anesthetics, it is unclear how much of this high-quality physiology and pharmacology actually applies to the clinical care of neurosurgical patients, in particular those with intracranial mass lesions or those at risk for intraoperative cerebral ischemia. This article attempts to review the clinical aspects of the care of such patients and to define when our physiologic understanding is important and when it is largely irrelevant.