Anästhesie in Der Neurochirurgie
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Anasthesie in der Neurochirurgie ist ein Bereich unseres Fachgebietes, der gelegentlich als Stiefkind behandelt wird. Ein solcher Eindruck entsteht, wenn man nach deutschsprachi- gen Monographien, einschlagigen KongreB- oder Zeitschrifienbeitragen sucht. Jeder Anasthesist muB aber heute in der Lage sein, im Rahmen seiner klinisch-praktischen Tatigkeit zumindest die auBer- und innerklinische Erstversorgung Schadel-Hirn-traumati- sierter Patienten zu tibernehmen. Das Fehlen einer deutschsprachigen Monographie als Weiter- und Fortbildungsmoglichkeit war fUr die Veranstalter des Workshops, auf das dieser Band zuriickgeht, AnlaB genug, den Versuch zu unternehmen, eine tiberschaubare Monographie zu erarbeiten, die den moder- nen Aspekten anasthesiologischer Verfahren bei neurochirurgischen Eingriffen Rechnung tragt. Zutreffend haben CAMPKIN und TuRNER (1) in der Einleitung ihres Buches konstatiert, daB friiher Asphyxie und Anasthesie zu schwersten Schaden des Patienten gefUhrt haben und daB deshalb neurochirurgische Eingriffe in jenen Zeiten vorwiegend in Lokalanasthesie durchgefUhrt wurden. Wahrend der letzten zwei Jahrzehnte sind jedoch wesentliche Kenntnisse tiber Physiologie und Pathophysiologie, tiber den EinfluB der Pharmaka auf Hirndurchblutung und intrakra- nie11en Druck erarbeitet worden; so kann heute die Anasthesie in der Neurochirurgie als si- cher und komplikationsarm gelten. Die Indikationen fUr neurochirurgische Eingriffe wer- den durch die Probleme der Anasthesie nicht mehr eingeschrankt.
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