Outcomes 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.