Medicine, like other fields, has evolved from having generalist care to subspecialist care. With the recent growth in neuroscience, the role of neuro-anaesthesia in neurosurgery patients has become increasingly prominent. Neuro-anaesthesiologists are anaesthesiologists who specialize in anaesthesia for neurosurgeries, which involves surgical procedures involving the brain, spinal cord, and/or nervous system.
Let’s shine the limelight on them.
While general anaesthesiologists may provide care during brain and spine surgeries, the specialized role of a neuro-anaesthesiologist is indispensable in optimizing surgical condition. They possess extensive knowledge of the unique considerations and challenges involved in neurosurgery, such as maintaining precise control of blood flow in the brain (cerebral blood flow) and intracranial pressure.
For example, in cases of brain tumors located in different regions, there can be varying complications. When dealing with tumors at the back of the brain, which govern our conscious level, extra caution is required in controlling blood pressure, adjusting the anaesthesia dosage, and determining the appropriate ventilation strategy for the patient using a ventilator.
Furthermore, neuro-anaesthesiologists have unique skills specific to their field. They are capable of providing care for awake craniotomy, a procedure where brain surgery is conducted while the patient is awake. In this specialized role, a neuro-anaesthesiologist adeptly manages the delicate balance of ensuring the patient remains relaxed and calm while also maintaining their cooperation during the surgical procedure.
In high-risk neuro-vascular surgeries, they may even temporarily halt the patient’s heart, if necessary, using medication. This demonstrates the exceptional importance of the specialized field of anaesthesiology in ensuring optimal conditions and patient safety during intricate neurosurgeries.
In summary, neuro-anaesthesiologists and other anaesthesiologists alike possess indispensable expertise and contribute significantly to the success of surgeries. Operating behind the scenes, their meticulous attention to detail, broad knowledge of anaesthesia techniques, constant monitoring, and unwavering dedication to patient safety truly make them specialists in the background.
Dr Leong Kok Weng serves as a Consultant Anaesthesiologist at Beacon Hospital, Malaysia, and has completed a Fellowship in Neuro-anaesthesia & Trauma. He has developed a special interest in anaesthesia for critically ill and elderly patients, and for neuro-interventional procedures involving the brain and spine.