Anesthesia for Day Care Neurosurgery

Abstract

In this review, we will discuss the anesthetic approach to outpatient neurosurgical procedures: craniotomy for tumor, anterior cervical decompression and fusion, and lumbar discectomy. The anesthesia team must be involved for the entire perioperative period: preoperative screening in preadmission clinic to optimize patient comorbidities and to assess suitability for same-day discharge; judicious sedation and anesthesia with short-acting agents and minimally invasive surgical techniques to expedite surgeries and minimize complications; and aggressive treatment of pain, nausea, and vomiting coupled with vigilance for complications and assessment of readiness for discharge. Successful day surgery programs focus on patient safety, optimized surgical and anesthetic techniques, and the selection and education of appropriate patients. The safety and feasibility of ambulatory neurosurgery depend on the development of stringent protocols and collaboration from nursing, surgery, and anesthesia teams.