Preanesthetic Evaluation and Preparation for Neurosurgical Procedures: An Indian Perspective

Abstract

Background A questionnaire-based survey was conducted to determine the preanesthetic evaluation (PAE) practices among the members of the Indian Society of Neuroanesthesiology and Critical Care (ISNACC). The survey aimed to assess the current clinical practice of PAE and optimization of neurosurgical patients in India. Methods An online questionnaire was designed by the working group of ISNACC and circulated among its active members. Response to individual questions was considered significant if 50% or more respondents concurred. The survey questions to which less than 50% of respondents concurred were identified as inconclusive results. Results Out of 438 active ISNACC members, 218 responded. Responses were obtained from various parts of the country. The majority of participants were practicing neuroanesthesiology. Questions asked were regarding clinical assessment, preoperative optimization, prognostication, and airway management in neurosurgery. More than 50% of practitioners acceded to most of the questions; however, the percentage of responses varied across different questions (50–100%). The questions related to preoperative duplex scanning in chronically immobilized patients, preoperative cognitive testing, and risk stratification during neurosurgical procedures received an inconclusive response (< 50%). Conclusion The survey highlights the variable PAE practices perused by ISNACC members across the country. A guideline for uniform PAE practices may help to enhance research and improve perioperative care.

Manajemen Anestesi pada Kraniotomi Pengangkatan Tumor Meningioma dengan Riwayat Operasi Kliping Aneurisma: Studi Kasus

“…4 Terdapat berbagai macam tumor otak yang biasanya ada bersamaan dengan aneurisma serebri, mulai dari meningioma, adenoma pituitari, glioma, lipoma, dan tumor metastasis. 5 Rencana anestesi pada kondisi 2 patologi otak ini membutuhkan pemahaman terkait penyakit neurovaskular dan prosedur pembedahan terkait. Kondisi pembuluh darah pasca kliping harus tetap diwaspadai, karena rentang keamanan yang cukup sempit antara tekanan darah yang tinggi yang dapat menyebabkan pecah pembuluh darah serta rendahnya tekanan darah yang dapat menyebabkan iskemia otak.…”

Untitled

“…The information collected is published in the current issue of Journal of Neuroanesthesiology and Critical Care (JNACC). 1 In neurosurgical literature, several studies reported many preoperative predictive factors that influence the outcome of the patients. These factors have to be given due importance in the preoperative assessment of a neurosurgical patient.…”