ANESTHESIA FOR NEUROSURGICAL PROCEDURES

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Abstract
Anoxia, swelling of the brain, and excessive bleeding create the greatest dangers to successful neurosurgical procedures. Anoxia starts a vicious cycle by causing increased permeability of the capillaries, which results in loss of fluid into the tissues, and this, in turn, leads to greater degrees of tissue anoxia. Increased volume of the brain may be caused by cerebral edema or vascular engorgement and necessitates more retraction by the surgeon to expose the operative field correctly. Excessive bleeding also results in cerebral edema, obscuring of the surgical field and, consequently, greater cellular damage. The prevention of anoxia and cerebral edema is the main goal of the anesthesiologist; the problem of bleeding remains the concern of the surgeon. Neurosurgery presents problems in anesthesia that are not confronted in other types of surgery. In this type of surgery patients are seen who are in varying degrees of consciousness; some have increased intracranial pressure,

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