Anestezija kod bolesnika sa neurološkim oboljenjima - koma (neurološka oboljenja i anestezija)

Abstract

Neurological disorders have increasing prevalence. Patients who come for surgery and anesthesia are more common with neurological comorbidities. This comorbidity, which has significant consequences for the behavior, psychological and physical characteristics of patients, has a need for numerous medications. When meeting these patients, anesthesiologists want answers to the following questions: the duration of the disease and the degree of illness, used therapy, the quality of life, the influence of anesthetics on the disease and the effect of therapy on the performance of anesthesia, the continuation of therapy after intervention and postoperative recovery. Still there are two dilemmas, whether and when before anesthesia and surgical interventions to stop the use of drugs that allow the function of patients and what are the possible interactions of drugs with anesthesia? The most common neurological diseases with which the anesthesiologist face as comorbidities are: Alzheimer's disease, Parkinson's disease, multiple sclerosis, epilepsy, circulatory disorders, and lately increases the likelihood of coma patients. Answering on the questions above will help a doctor to decide on the type of anesthesia and which dosage of drugs he will use. If a patient is without restrictions in work and habits, then anesthesia in this case is the same as in a person without this comorbidity. The therapy for the existing disease should be carried out until surgery or anesthesia, and should be continued immediately after surgery. Due to the significant influence of used drugs and the nature of the disease, it is necessary to use lesser doses of relaxants, opioids and sedatives. The use of regional anesthesia has its place, and it is used when the degree of illness is such that it allows the patient to cooperate.