Outcomes in neuroanesthesia: What matters most?

Area of Science:

• Neuroanesthesia
• Clinical Outcomes Research
• Neurosurgery

Background:

• Established knowledge base on anesthetic effects on various outcomes in neurosurgery.
• Limited but cautious translation of animal data to clinical patient care.
• Historical focus on short-term perioperative outcomes in neuroanesthesia research.

Purpose of the Study:

• To review and categorize clinically relevant outcomes in neuroanesthesia.
• To propose priority outcomes for clinical care and future research.
• To advocate for a shift towards long-term and disease-specific patient outcomes.

Main Methods:

• Narrative review of existing neuroanesthesia literature.
• Analysis of investigated clinical outcomes.
• Identification of research gaps and future directions.

Main Results:

• Neuroanesthesia research has built a foundational understanding of anesthetic impacts.
• Current research predominantly addresses short-term outcomes, with limited animal-to-patient data translation.
• The term "neurologic outcome" requires a more precise definition, potentially integrating multiple measurement scales.

Conclusions:

• Future neuroanesthesia research should emphasize prospective randomized trials.
• Focus should shift to long-term neurologic outcomes crucial for patients.
• Multi-center coordination via a clinical trials network is essential for advancing research.