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Neurosurgical Anesthesia

What is Neuroanesthesia or Neurological Anesthesia?
Neurosurgical anesthesia or neuroanesthesia focuses on patients undergoing brain or spinal cord surgery. This type of surgery is called neurosurgery.

What Makes Neurosurgical Anesthesia or Neuroanesthesia Different?
There are many similarities between neurosurgical and general anesthesia. Neuroanesthetic management, however, is different because it can have a major effect on the brain and spinal cord through the control of blood flow, blood pressure and energy consumption of these organs. Southeast Anesthesiologists specializing in neurosurgical anesthesia have extensive training regarding.

  • Brain and spinal cord physiology or function including blood flow dynamics and metabolism
  • Changes of brain and spinal functions due to disease, as well as of intracranial pressure and cerebral edema
    • Definitions
      • Intracranial pressure – pressure that occurs within the cranium or skull.
      • Cerebral edema - swelling in the brain.

What are neuroanesthesia techniques?
The type of anesthesia being used depends on the type of surgery being performed. There are several specialized anesthetic techniques that might be used during your surgery, these may include but are not limited to:

  • Evoked Potential Monitoring – Evoked potential is when an electrical signal travels through the nerves, up the spinal column and into the brain. This process is called evoked potential because it is a potential electric voltage that is caused, or “evoked” by stimulation. Anesthesiologists use evoked potential monitoring in order to monitor the neural pathways in your brain and spine while you are asleep. There are a variety of monitoring devices whose use will depend on the type of surgery being performed.
    Types of Evoked Potential Monitoring Include:
    • Brainstem Auditory Evoked Potential Monitoring (BAEP) is used to measure brain wave activity in or around the auditory nerves in your brain.
    • Somatosensory Evoked Potential Monitoring (SEP Monitoring) is used to monitor the function of your sensory pathways in your spinal cord and brain during surgery.
    • Motor Evoked Potential Monitoring (MEP monitoring) is used to monitor the function of your motor (muscle) pathways in your spinal cord and brain during surgery.
  • Induced hypothermia is done to prevent damage to your brain tissue.
  • When would I have an anesthesiologist that specializes in neurosurgery?
    There are a wide range of cases that would require the need of an anesthesiologist that specializes in neurological anesthesia. Some of these include:

    • extra and intracranial (aneurysms and arterio-venous malformations) vascular surgery
    • benign and malignant intracranial tumors
    • craniobasal and craniofacial surgery
    • transsphenoidal pituitary surgery
    • posterior craniotomies
    • head trauma
    • pediatric neurosurgery
    • stereotactic and brain biopsy procedures
    • spinal surgery

    What is a sitting craniotomy?
    Certain surgeries on the brain or neck may require the patient to be in a sitting position. Also known as a sitting craniotomy, this position gives the surgeon a better view of the head area and minimizes blood loss.

    Surgery in the sitting position involves special anesthesia techniques and may require the placement of additional monitoring devices to ensure a safe anesthetic result. Your anesthesiologist will discuss the necessity of these and other procedures with you prior to the time of surgery.

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