Pregledni rad
https://doi.org/10.20471/acc.2023.62.s1.15
Airway Management in Neuroanesthesia
Tamara Murselović
; Department of Anesthesiology, Resuscitation and Intensive Care Medicine, Sveti Duh University Hospital, Zagreb, Croatia
Alka Makovšek
; Department of Anesthesiology, Resuscitation, Intensive Medicine and Pain Therapy, Zagreb University Hospital Center, Zagreb, Croatia
Sažetak
Neurosurgical patients have specific airway management. Various conditions and
diagnoses make intubation difficult and may also cause neurological damage. Spinal pathology, neurotrauma,
cervical spine surgery, and pituitary gland surgery are just some examples. The aim of this
review article is to present a broad spectrum of neurosurgical operations and potential complications in
maintaining airway patency related to these issues. Quality perioperative preparation is a prerequisite to
avoid the potentially irreversible consequences of difficult airways with a poor neurological or even fatal
outcome. Patients with tumors of the pituitary region who present with Cushing’s disease are prone to
difficult ventilation, tracheal obstruction and difficult intubation. Awake craniotomy is also a challenge
for the anesthesiologist, given that access to the airway is problematic due to the fixed frame. Unstable
cervical spine occurs in cases of rheumatoid arthritis or blunt trauma, requiring precautions to be taken
with spinal stabilization during intubation and induction. Pharyngeal edema and hematomas, possible
complications of cervical spine surgery can endanger airway patency after extubation; postoperative patient
supervision is thus required. Due to the potential threat to the patient’s airway during neurosurgical
procedures, quality anesthetic preoperative preparation is necessary to avoid irreversible damage and
death.
Ključne riječi
Neuroanesthesia; Difficult airway; Intubation
Hrčak ID:
307514
URI
Datum izdavanja:
1.4.2023.
Posjeta: 255 *