What are the factors that you should consider when administering general anesthetic?

General Considerations

• Unarousable to painful stimuli.
• Unable to remember what happened (amnesia)
• Unable to maintain adequate airway protection and/or spontaneous ventilation as a result of muscle paralysis.
• Cardiovascular changes secondary to stimulant/depressant effects of anesthetic agents.

What are the contraindications of anaesthesia?

Contraindications for local anaesthetics

• Previous allergic reaction to local anaesthetic.
• Inflamed or Infected tissues- unlikely to have effect if used locally due to low pH of tissue.
• Caution in patients with family history of malignant hyperthermia.

What does a Neuroanesthesiologist do?

The neuroanesthesiologist helps achieve optimal operating conditions for the neurosurgeon while ensuring the patient maintains unconsciousness, good brain blood flow and oxygen levels, and receives appropriate pain management during and after the procedure.

What are the three components to anesthesia?

∎ General anaesthesia often comprises a triad of hypnosis, analgesia and muscle relaxation.

What are complications of anesthesia?

Important complications of general anaesthesia

• Pain.
• Nausea and vomiting – up to 30% of patients.
• Damage to teeth.
• Sore throat and laryngeal damage.
• Anaphylaxis to anaesthetic agents – approximately 1 in 3,000.
• Cardiovascular collapse.
• Respiratory depression.

When do you give a mannitol in craniotomy?

Mannitol, an osmotic agent, has been widely used to reduce the volume of the brain, the intracranial pressure and to facilitate the surgical approach in reducing the risk of cortical lesions during the opening of the skull. Mannitol 20% is usually given intravenously in bolus doses of 0.5-1g/kg over 30 minutes.

Why is isoflurane preferred in neurosurgery?

Of all the available halogenated anaesthetic agents, isoflurane appears to be the most advantageous for the neurosurgical patient. Concentrations which produce satisfactory anaesthesia for neurosurgical procedures cause little or no depression of myocardial function, and no increase in intracranial pressure.

What are the complications of anesthesia?

What are surgery risk factors?

Surgical risk factors include direct intraoperative trauma or stretch, vascular compromise, perioperative infection, hematoma formation, prolonged tourniquet ischemia, or improperly applied casts or dressings.

What is the most common side effect of general anesthesia?

The most common complications after general anesthesia are nausea and vomiting. You’re more likely to experience postoperative nausea and vomiting (PONV) if you have a history of nausea and vomiting after previous surgery. Anti-nausea medication can usually be given before surgery to prevent PONV.

When do you use mannitol for head injury?

For other patients, the Brain Trauma Foundation Guidelines Task Force of the American Association of Neurological Surgeons and Joint Section in Neurotrauma and Critical Care (Task Force 1995) recommend that mannitol be used only if the patient has signs of raised intracranial pressure (ICP) or deteriorating …

What anesthesia is used for neurosurgery?

Synthetic opioids such as alfentanil, fentanyl, sufentanil, and the newer remifentanil are commonly used in neurosurgical anesthesia owing to their short duration of action and their ability to minimize cortical effects through continuous infusion.

What anesthesia is used for brain surgery?

General anesthesia is frequently used and is especially important for high-precision tumor removal because you must remain absolutely still. Under general anesthesia, you will be unconscious throughout the operation. Some surgeries are done under monitored anesthesia care or sedation.

What are the 10 potential risk factors related to surgery?

Understanding potential risk factors will help you and your physician anesthesiologist prepare for a safer surgery.

• Obesity.
• Age.
• Smoking.
• Sleep Apnea.
• Anesthesia Awareness (Waking Up) During Surgery.

What does a Neuroanesthesia Division anesthesiologist do?

The anesthesiologists in the Neuroanesthesia Division play a critical role in controlling and monitoring patient conditions in addition to ensuring pain management during and after these procedures.

Why choose a neuroanesthesiologist at Johns Hopkins?

Our neuroanesthesiologists provide care in the general neurosurgical operating rooms and in the neurointerventional radiology suites at Johns Hopkins Hospital. Patients in these settings receive personalized anesthetic combinations to accomplish the surgical goals of these complex and nuanced procedures.

What is the goal of anesthesia in the treatment of spinal injuries?

Anesthetic Considerations. Goal is to reduce the incidence of secondary injuries, thus stabilization is key. Beware of spinal shock (loss of sympathetic innervation) in these patients, and treat with fluids, vasopressors if needed, and atropine if cardiac accelerator nerves [T1-T4] are affected.

What are the additional means of anesthesia during a craniotomy?

Additional means include administration of thiopental or lumbar catheter drainage (if available) Following the craniotomy and dural incision, anesthetic requirements drop substantially, as the brain itself is insensate.