ANESTHETIC AGENTS - TOTAL INTRAVENOUS OR INHALATION ANESTHESIA FOR NEUROSURGICAL PROCEDURES

In this review article the pro's and contra's of the use of either inh alational or intravenous anaesthetics for neurosurgical procedures are discussed. The objective is to stimulate thoughts concerning controve rsial subjects, rather than to resolve issues, It is much less complic ated to approach the practice of neuroanaesthesia with a few straight forward << rules >> based on laboratory measurements (such as intraven ous drugs are good because they reduce CBF and ICP, whereas inhalation al agents are bad because they increase CBF and ICP). It should also b e noted that wehereas statements about potential detrimental or benefi cial effects of different anaesthetic agents are relatively common, th ere is a dearth of well-designed prospective studies of sufficient pow er to substantiate the outcome advantages or disadvantages. The choice of an anaesthetic should include more than just a consideration of th e potential intracranial effects of a drug: it should also include exp erience with a drug and, more important a consideration of the patient as a whole.