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[Total intravenous anesthesia in neurosurgery. Our clinical experience]
P Mastronardi1, A Del Gaudio, P Ciritella
1Istituto di Anestesia e Rianimazione, Facoltà di Medicina e Chirurgia, Università degli Studi di Napoli Federico II, Napoli.
Background:
The quality of a "neuroanesthetic" technique is the result of its pharmacokinetics, of its effect on intracerebral homeostasis and metabolism, of its antinociceptive and neuroprotective features. Aim of this study is to test the effectiveness of TIVA as the technique of choice in neurosurgical patients throughout a retrospective analysis of 1982 patients scheduled for brain tumors, neurovascular surgery and spine lesions.
Methods:
1982 patients (1023 F, 959 M), ASA I-IV, aging 15-80 yrs scheduled for neurosurgery were studied. Hemodynamic and electrophysiological parameters were monitored carefully. Time of recovery was evaluated although this parameter is influenced by perioperative clinical status and by area and kind of brain damage.
Results:
A good hemodynamic stability was observed. Recovery time was quick, related with brain damage and time of surgery. Incidence of postoperative nausea, vomiting and seizures was very low. Two cases of awareness were noted.
Conclusions:
1982 neurosurgical operations were carried out in TIVA without major complications and side effects: the authors are therefore sure that TIVA can be considered the anesthetic technique "of choice" in neurosurgical patients.