Anesthesiological methods in acoustic neuroma surgery

Anesthesiological methods in acoustic neuroma surgery
Alisher Agzamov MD PhD
Department of Anaesthesiology & ICU, KCCC, Kuwait City, Kuwait

Background: The removal of acoustic neuromas may often imply anesthesiological as well as surgical problems, especially in the case of large tumors (> 3 cm) which
may have come into contact with vital neighbouring structures (brain stem, cerebellum).

Objectives: We have study of the use of two different anesthesiological methods during the translabyrinthine approach is analyzed and discussed in the light of the
different needs in this type of surgery.

Methods: More specifically, anesthesia maintenance was assured by constant infusion of either TCI Propofol or Desflurane (5- 8 %). Withdrawal of curarization by Cisatracurium was also planned in order to allow the surgeon to take advantage of routine intraoperative facial nerve monitoring. Arterial pressure, CO2 and O2 were
assessed at prefixed phases of the operation.

Results and Conclusions: Both anesthesiologic methods proved to be satisfactory during the entire surgical procedure. During dissection of the tumoral capsule, an
increased heart rate (7% of the initial value) was noticed, whilst in only three patients (with tumors larger than 3.5 cm) a severe bradycardia, which did not respond to
Atropine administration and which subsided spontaneously during temporary suspension of surgical manoeuvres, occurred. After this preliminary experience, we
believe that both techniques could have a major role in translabyrinthine acoustic tumor surgery and auspicate their further application.