[Electro-anaesthesia during neuro-surgery (author's transl)]

Area of Science:

• Neurosurgical Anesthesia
• Pain Management
• Electrical Stimulation

Context:

• Neurosurgery requires specialized anesthetic techniques to manage patient safety and physiological stability.
• Traditional anesthetic methods may carry risks, especially for high-risk surgical candidates.
• Exploring novel analgesic strategies is crucial for optimizing neurosurgical outcomes.

Purpose:

• To evaluate the efficacy and safety of electro-anaesthesia supplemented with neuroleptics and pancuronium in neurosurgical procedures.
• To assess the reduction in supplementary analgesic drug requirements (fentanyl) during electro-anaesthesia.
• To determine the suitability of electro-anaesthesia for high-risk neurosurgical patients, including those undergoing posterior fossa surgery.

Summary:

• Sixty-six cranial or spinal operations were conducted using electro-anaesthesia, characterized by Limoge's high-frequency currents for analgesia, neuroleptics, and pancuronium.
• The protocol involved neuroleptic induction, electrical stimulation, intubation, controlled ventilation (50% O2/50% N2O), and muscle relaxants.
• Fentanyl use was reduced by 90% (average 0.46 µg/kg/hr), with only 3 absolute failures. Patients recovered well, with extubation averaging 16 minutes. Cough and swallowing reflexes were preserved, indicating maintained respiratory function.

Impact:

• Electro-anaesthesia demonstrates a significant reduction in opioid analgesic requirements, improving patient recovery and potentially reducing side effects.
• Preservation of respiratory reflexes (cough, deglutition) is a key advantage, particularly beneficial for neurosurgical patients.
• This technique shows promise as a safe and effective anesthetic option for high-risk neurosurgical patients, especially for posterior fossa procedures.