The year in review – neuroanaesthesia and neurointensive care

Czech version

Authors: V. Dostálová; P. Dostál
Authors‘ workplace: Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice Hradec Králové, Lékařská fakulta v Hradci Králové, Univerzita Karlova
Published in: Anest. intenziv. Med., 30, 2019, č. 6, s. 265-270
Category:

Overview

The development of surgical techniques requires the introduction of new anaesthetic approaches. In neuroanesthesia, the emphasis is placed on the so-called multimodal approach to conducting anesthesia. The use of Dexmedetomidine allows us to extend the indications for resection of tumours in the eloquent areas as well as to patients with expected difficult airway management, especially during reintubation in the last phase of surgery. Also, reduction in the incidence and severity of delirant conditions in the phase of awakening during surgery is possible by replacing general anesthesia with sedation using Dexmedetomidine. We comment on the results of the first prospective study on the safety of head elevation with regard to the incidence and severity of venous air embolism, and studies comparing general anesthesia vs. sedation in patients with ischaemic stroke (results of subgroup analysis of DEFUSE 3).

From the realm of neurointensive care, we present the results of a study examining the effect of tranexamic acid on the extent and clinical outcomes of patients with spontaneous intracerebral hemorrhage (CRASH-3 study), the effects of introduction of the so-called minimal invasive intervention in spontaneous intracerebral hemorrhage (MISTIE 3 study) and transfusion safety study in severe brain injury (TRAHT study). Last but not least, we have introduced new recommendations in the care of severe brain injuries in adults (SIBICC).

Keywords:

anaesthesia – neurosurgery – intensive care – literature in medicine

Sources

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