RECENT PROGRESS IN NEUROSURGICAL ANESTHESIA

Abstract

In this paper, the recent progresses in the neurosurgical anesthesia have been reviewed. It has been clarified now that following increase in intracranial pressure in the cases of head trauma, brain tumor and intracranial hemorrhage, catecholamine in blood will elevate and thus cardiac output, systemic and pulmonary arterial pressures, PCWP increase then myocardiac damage, increase in the intrapulmonary shunt, increase in pulmonary capillary permeability, hypercoagulability, increase in arterial FFA level, negative balance in nitrogen will be induced. It will be reasonably considered that isoflurane is superior than halothane or enflurane for neurosurgical anesthesia, because it will remarkedly less increase cerebral blood flow, decrease cerebral O₂ consumption, dose not change autoregulation of cerebral blood flow, does not increase CSF production and dose not change autoregulation of cerebral blood flow, does not increase CSF production and does not inhibit CSF absorption. It will be concluded that isoflurane anesthesia with supplemental use of barbiturate will be more excellent anesthesia method for neurosurgery comparing with NLA with nitrous oxide inhalation which usually accelerate the release of catecholamine by less inhibition of surgical stress.