General anaesthesia in patients with cerebrovascular diseases - risks and complications

Abstract

The aim of the study is to present the problems arising during general anesthesia in patients with cerebrovascular diseases, taking into account the appropriate perioperative preparation. When planning the anesthetic procedure strategies aimed at the prevention of cerebral ischemia or hemorrhage into the brain must be taken into account. Material and research methods: a descriptive analysis was applied on the basis of the literature collected from the years 1992 to 2013. Conclusions: Preoperative evaluation of patients with cerebrovascular disease requires a thorough neurological examination, assessment of cardiovascular complications, including the risk of cerebrovascular, respiratory, renal, and endocrine system complications. During general anesthesia one should take care of haemodynamic stability and proper ventilation parameters. The choice of anesthetic agents so that during the induction of anesthesia, throughout anesthesia, during the recovery from the anesthesia there is no risk of hemodynamic instability and an appropriate level of blood perfusion in the brain is maintained. In the postoperative period the neurological status of the patient should be assessed, in order to ensure that he does not demonstrate symptoms of delirium and that he does not experience a recurrence of previous neurological deficits. Each surgery and anesthesia should be discussed with the operator in terms of the risks and benefits of surgery. Scheduled surgery in patients with acute cerebrovascular incidents need to be postponed until their performance is reasonably safe for the patient.