18 Anesthesia Considerations for Neurovascular Procedures

Carine Zeeni, John F. Bebawy, and Antoun Koht

Abstract

Neuroanesthesiologists play a key role in the periprocedural management of neurovascular patients. They evaluate and optimize patients preoperatively, work swiftly to avoid delays when emergency procedures take place, facilitate the surgeon’s or neurointerventionalist’s task by providing anesthesia, analgesia, and immobility during procedures, and manage the patient during the acute phase of recovery. All of the clinical choices that the neuroanesthesiologist makes are adapted to the patient’s individual needs and are tailored to the patient’s preexisting comorbidities while taking into account pathophysiological considerations, such as management of systemic hemodynamics, cerebral perfusion pressure, intracranial pressure, oxygenation, and airway protection. Neuroanesthesiologists are an integral part of the multidisciplinary team that works relentlessly to ensure the best possible outcomes for patients requiring neurovascular procedures.

Key words

neuroanesthesia - cerebral protection - general anesthesia - conscious sedation - neurophysiological monitoring

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