6533b828fe1ef96bd12879f3

RESEARCH PRODUCT

Inhaled anesthesia in neurosurgery: Still a role?

Rafael BadenesFederico BilottaJuan David PeñaConsolato Gianluca Nato

subject

medicine.medical_specialtyHypnosisBalanced Anesthesiabusiness.industrymedicine.medical_treatmentHemodynamicsBrainAnesthesia GeneralNeurosurgical ProceduresThird generationAnesthesiology and Pain MedicineOpioidAnesthesiaAnesthesia Recovery PeriodmedicineHumansIn patientNeurosurgeryAnesthesia InhalationbusinessDesfluraneNeurophysiological MonitoringCraniotomymedicine.drug

description

In patients undergoing craniotomy, general anesthesia should be addressed to warrant good hypnosis, immobility, and analgesia, to ensure systemic and cerebral physiological status and provide the best possible surgical field. Regarding craniotomies, it is unclear if there are substantial differences in providing general anesthesia using total intravenous anesthesia (TIVA) or balanced anesthesia (BA) accomplished using the third generation halogenates. New evidence highlighted that the last generation of halogenated agents has possible advantages compared with intravenous drugs: rapid induction, minimal absorption and metabolization, reproducible pharmacokinetic, faster recovery, cardioprotective effect, and opioid spare analgesia. This review aims to report evidence related to the use of the latest halogenated agents in patients undergoing craniotomy and to present available clinical evidence on their effects: cerebral and systemic hemodynamic, neurophysiological monitoring, and timing and quality of recovery after anesthesia.

https://doi.org/10.1016/j.bpa.2020.10.004