Category Archives: General Anesthesia

Cranial Base Surgery

Lesions requiring Cranial Base Surgery represent a heterogeneous group of lesions and vascular malformations associated with cranial base bony structures. These pathologies provide a challenging situation for both neurosurgeon and neuroanaesthesiologist. There is abundance of structures especially vital centers in Continue reading

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Emergence from anesthesia

Emergence from anesthesia has cardiorespiratory, metabolic/endocrine and neurologic consequences. Awakening and extubation after anesthesia are associated with haemodynamic arousal lasting 10-25 minutes. This activation is partially mediated by elevations in catecholamine levels and partially by nociceptive stimuli. The aim of Continue reading

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Cerebral Aneurysm Clipping

Skull is a fixed vault and most intracerebral structures are relatively incompressible, hence even a small haemorrhage can result in a significant anatomic distortion producing significant rise in ICP and reduction in cerebral perfusion. Cerebral Aneurysm Clipping is one of the Continue reading

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Postoperative Nausea and Vomiting (PONV)

Postoperative Nausea and Vomiting (PONV) is one of the most distressing experiences associated with surgery, and many patients find it more troublesome than postoperative pain itself. It is not only very uncomfortable to the patient in the postoperative period but it Continue reading

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Awake Craniotomy Anesthesia

The anesthesiologist should know that the essential element of an “anesthetic” for an Awake Craniotomy Anesthesia is the surgeon’s local anesthetic technique. Craniotomy is required for removal of space occupying lesions, intracranial vascular pathologies and for drainage of extradural or Continue reading

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Arteriovenous Malformations AVMs

The reduced cerebrovascular resistance at the site of Arteriovenous Malformations AVMs lead to an increase in blood flow to this area and the formation of a lower resistance shunt along with peri-infarction oedema. They usually represent a high-flow and low-resistance Continue reading

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Anesthesia in Neurological Disease

Patients with primary neurodegenerative undergoing Anesthesia in Neurological Disease  (Parkinson’s disease, Huntington’s chorea, Alzheimer’s, amyotrophic lateral sclerosis ) or demyelinating diseases (Guillain-Barre’ syndrome, multiple sclerosis, myeloneuropathies) suffer from progressive and sometimes incurable neurologic impairment, neuromuscular involvement, dysautonomia and pulmonary insufficiency. Continue reading

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Anesthesia for Posterior Fossa Surgery

Posterior fossa is a tight infratentorial compartment which harbors vital centers like cerebellum, pons and medulla. Anesthesia for Posterior Fossa Surgery  is employed in carious types of space-occupying lesions, i.e., cerebellar tumours, cerebellopontine angle lesions, medulloblastoma, brainstem glioma occur in this Continue reading

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Anesthesia for Cerebral Aneurysm

Minimization of the risk of aneurysm rupture during Anesthesia for Cerebral Aneurysm demands smooth induction and maintenance of optimum transmural pressure (TMP) gradient. TMP is the difference between mean arterial pressure (MAP) and ICP. Rise in MAP or fall in Continue reading

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Acoustic Surgery

Acoustic Surgery can be accomplished with suboccipital, translabyrinthine and middle fossa approaches. The sitting, supine, lateral or park-bench position can be used for the suboccipital approach. Small or medium sized tumours are associated with essentially no mortality, whereas large tumors Continue reading

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