Neuroanesthesia  

•    Neurosurgical Anesthesiology

The advent of anaesthetics was one of the most significant influences on the evolution of neurosurgery in the nineteenth century. The purpose of any neurosurgical anesthesia is to keep the central nervous system perfused and oxygenated while the surgery is being performed. The surgeon's physical manipulation (or mechanical manipulation by retraction), adverse venous drainage caused by the patient's positioning, sympathetic stimulation, intravascular fluid shifts, and variations in respiratory physiology all have an impact on cerebral blood flow (CBF) and, ultimately, tissue viability. The intricate balance between oxygen demand and delivery that occurs during anesthesia necessitates knowledge of the neurophysiologic effects of drugs used to maintain amnesia, immobility, and analgesia. The area of neuroanesthesiology is vast, with the primary goal of treating and caring for patients with neurologic disorders. The primary concern of neuroanesthesia is the regulation of brain volume and pressure, which can be accomplished by controlling respiratory pattern and CO2 blood gas tensions, administering diuretics, or administering hypertensive agents, all of which cause physiologic changes that are critical to the case's success. The other main issue is controlling blood loss, which can be controlled by the anesthesia used, blood pressure control, and ventilation. The final and most important responsibility is to safeguard nerve tissue.