Anesthesia for Neurosurgical Procedures

The central nervous system (CNS) is a complicated network of neurons that integrates a myriad of sensory input from both inside and outside the body and eff ects motor responses. The CNS consists of neurons, oligodendrites, and support cells such as microglia. Abnormal CNS development can result in devastating injury to young children, making the administration of general anesthesia very challenging. In order to successfully care for children undergoing neurosurgical procedures, it is essential to understand the interaction between the disordered CNS and the anesthetic milieu. In this chapter we review the general principles of anesthetic management of infants and neonates undergoing neurosurgical procedures. The purpose of this chapter is not to give recipes for treating infants and neonates for various neurosurgical procedures. Rather, we hope to give the reader an understanding of the variety of anesthetic considerations when caring for babies that are neurosurgical patients.