Anesthesia for excision of vestibular schwannoma.

Q2 Medicine

Handbook of clinical neurology Pub Date : 2025-01-01 DOI:10.1016/B978-0-12-824534-7.00027-5

Joseph Sebastian

引用次数: 0

Abstract

Anesthesia for the resection of vestibular schwannomas poses unique challenges; operative times are long, typically between 8 and 12h, during which there are varying levels of surgical stimulation. Close attention to positioning is essential to minimize skin damage, neuropraxia, and optimize surgical access. The delicate nature of microsurgical resection requires absolute patient immobility; this is made more demanding by the need to avoid neuromuscular blocking drugs to facilitate continuous electromyographic (EMG) monitoring of the facial nerve. The choice of anesthetic should enable this and allow for prompt postoperative assessment of neurologic function after prolonged exposure to these agents. Surgery on the vestibular apparatus can be a potent stimulus for postoperative nausea and vomiting, and postoperative control of these symptoms is important in order to optimize recovery.

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前庭神经鞘瘤切除术的麻醉。

麻醉切除前庭神经鞘瘤提出了独特的挑战；手术时间很长，通常在8到12小时之间，在此期间有不同程度的手术刺激。密切关注体位对于减少皮肤损伤、神经失用症和优化手术通路至关重要。显微手术切除的微妙性质要求患者绝对不能动；由于需要避免使用神经肌肉阻断药物，以促进对面神经的连续肌电图监测，这一要求变得更加苛刻。麻醉的选择应该能够实现这一点，并允许在长时间暴露于这些药物后及时进行术后神经功能评估。前庭器官的手术可能是术后恶心和呕吐的有力刺激，术后控制这些症状对于优化恢复很重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Handbook of clinical neurology Medicine-Neurology (clinical)

CiteScore

4.10

自引率

0.00%

发文量

302

期刊介绍： The Handbook of Clinical Neurology (HCN) was originally conceived and edited by Pierre Vinken and George Bruyn as a prestigious, multivolume reference work that would cover all the disorders encountered by clinicians and researchers engaged in neurology and allied fields. The first series of the Handbook (Volumes 1-44) was published between 1968 and 1982 and was followed by a second series (Volumes 45-78), guided by the same editors, which concluded in 2002. By that time, the Handbook had come to represent one of the largest scientific works ever published. In 2002, Professors Michael J. Aminoff, François Boller, and Dick F. Swaab took on the responsibility of supervising the third (current) series, the first volumes of which published in 2003. They have designed this series to encompass both clinical neurology and also the basic and clinical neurosciences that are its underpinning. Given the enormity and complexity of the accumulating literature, it is almost impossible to keep abreast of developments in the field, thus providing the raison d''être for the series. The series will thus appeal to clinicians and investigators alike, providing to each an added dimension. Now, more than 140 volumes after it began, the Handbook of Clinical Neurology series has an unparalleled reputation for providing the latest information on fundamental research on the operation of the nervous system in health and disease, comprehensive clinical information on neurological and related disorders, and up-to-date treatment protocols.