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神经外科麻醉:通过药物选择优化治疗效果。

Neurosurgical Anesthesia: Optimizing Outcomes with Agent Selection.

作者信息

Nguyen Andrew, Mandavalli Akhil, Diaz Michael Joseph, Root Kevin Thomas, Patel Aashay, Casauay Jed, Perisetla Priyanka, Lucke-Wold Brandon

机构信息

College of Medicine, University of Florida, Gainesville, FL 32611, USA.

Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA.

出版信息

Biomedicines. 2023 Jan 27;11(2):372. doi: 10.3390/biomedicines11020372.

Abstract

Anesthesia in neurosurgery embodies a vital element in the development of neurosurgical intervention. This undisputed interest has offered surgeons and anesthesiologists an array of anesthetic selections to utilize, though with this allowance comes the equally essential requirement of implementing a maximally appropriate agent. To date, there remains a lack of consensus and official guidance on optimizing anesthetic choice based on operating priorities including hemodynamic parameters (e.g., CPP, ICP, MAP) in addition to the route of procedure and pathology. In this review, the authors detail the development of neuroanesthesia, summarize the advantages and drawbacks of various anesthetic classes and agents, while lastly cohesively organizing the current literature of randomized trials on neuroanesthesia across various procedures.

摘要

神经外科麻醉是神经外科手术发展中的一个重要因素。这种无可争议的关注为外科医生和麻醉医生提供了一系列可供使用的麻醉选择,不过在有这种选择余地的同时,也同样需要使用最合适的药物。迄今为止,在根据包括血流动力学参数(如脑灌注压、颅内压、平均动脉压)以及手术途径和病理情况等手术重点来优化麻醉选择方面,仍缺乏共识和官方指导。在本综述中,作者详细阐述了神经麻醉的发展历程,总结了各类麻醉药物和制剂的优缺点,最后还全面梳理了目前有关各类神经外科手术神经麻醉的随机试验文献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74ed/9953550/cef0257629d6/biomedicines-11-00372-g001.jpg

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