Anestesia en tumores supratentoriales.

Autores/as

  • Rocío Rodríguez Contreras Facultativo Especialista de Anestesiología y Reanimación, Hospital Universitario Torrecárdenas, Almería.
  • A Vega Salvador Facultativo Especialista de Anestesiología y Reanimación, Hospital Universitario Torrecárdenas, Almería.
  • Elisabeth Reche Navarro Facultativo Especialista de Anestesiología y Reanimación, Hospital Universitario Torrecárdenas, Almería.
  • J Estévez Santiago Facultativo Especialista de Anestesiología y Reanimación, Hospital Universitario Torrecárdenas, Almería.

DOI:

https://doi.org/10.30445/rear.v15i5.1145

Palabras clave:

Anestesia, Craneotomía supratentorial, tumores supratentoriales, masa cerebral, hinchazón, Meningioma resection, Resección de glioma, Neurocirugía, Relajación cerebral

Resumen

Los tumores supratentoriales (TS) son los tumores primarios más frecuentes del sistema nervioso central. Su manejo anestésico exige un profundo conocimiento de la fisiología cerebral y debe ir enfocado a mantener una adecuada perfusión cerebral, evitar agresiones cerebrales secundarias, favorecer unas condiciones quirúrgicas óptimas a través del control de la presión intracraneal, lograr una adecuada neuromonitorización y facilitar un despertar rápido y suave que permita, en ausencia de complicaciones, una evaluación neurológica precoz. El manejo adecuado de estos pilares tendrá un impacto directo en el resultado neuroquirúrgico y en el pronóstico del paciente tras la resección. El objetivo de esta revisión es proporcionar un resumen actualizado de la evidencia y conocimientos que debe poseer un anestesiólogo en el manejo de la craneotomía de TS. Para llevar a cabo este documento, se ha realizado una búsqueda no sistemática de la literatura en las bases de datos PubMed y Cochrane en los últimos veinte años, con fecha de actualización abril 2022, utilizando las palabras clave “anesthesia” “supratentorial brain tumor” “supratentorial craniotomy” “brain bulk”.

Citas

- Lapointe S, Perry A, Butowski NA. Primary brain tumours in adults. Lancet Lond Engl 2018;392:432–46. https://doi.org/10.1016/S0140-6736(18)30990-5.

- Ostrom QT, Cioffi G, Gittleman H, Patil N, Waite K, Kruchko C, et al. CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2012-2016. Neuro-Oncol 2019;21:v1–100. https://doi.org/10.1093/neuonc/noz150.

- Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol (Berl) 2016;131:803–20. https://doi.org/10.1007/s00401-016-1545-1.

- Gruenbaum SE, Meng L, Bilotta F. Recent trends in the anesthetic management of craniotomy for supratentorial tumor resection. Curr Opin Anaesthesiol 2016;29:552–7. https://doi.org/10.1097/ACO.0000000000000365.

- Ayrian E, Kaye AD, Varner CL, Guerra C, Vadivelu N, Urman RD, et al. Effects of Anesthetic Management on Early Postoperative Recovery, Hemodynamics and Pain After Supratentorial Craniotomy. J Clin Med Res 2015;7:731–41. https://doi.org/10.14740/jocmr2256w.

- Sharma D, Bithal PK, Dash HH, Chouhan RS, Sookplung P, Vavilala MS. Cerebral autoregulation and CO2 reactivity before and after elective supratentorial tumor resection. J Neurosurg Anesthesiol 2010;22:132–7. https://doi.org/10.1097/ANA.0b013e3181c9fbf1.

- Soliman RN, Hassan AR, Rashwan AM, Omar AM. Prospective, randomized controlled study to assess the role of dexmedetomidine in patients with supratentorial tumors undergoing craniotomy under general anesthesia. Middle East J Anaesthesiol 2011;21:23–33.

- Matta BF, Menon DK, Smith M. Core topics in neuroanaesthesia and neurointensive care. Cambridge: Cambridge University Press; 2011.

- Prabhakar H, Ali Z, editors. Textbook of Neuroanesthesia and Neurocritical Care: Volume I - Neuroanesthesia. Singapore: Springer Singapore; 2019. https://doi.org/10.1007/978-981-13-3387-3.

- Greenhalgh J, Weston J, Dundar Y, Nevitt SJ, Marson AG. Antiepileptic drugs as prophylaxis for postcraniotomy seizures. Cochrane Database Syst Rev 2020;4:CD007286. https://doi.org/10.1002/14651858.CD007286.pub5.

- Galvin IM, Levy R, Boyd JG, Day AG, Wallace MC. Cooling for cerebral protection during brain surgery. Cochrane Database Syst Rev 2015. https://doi.org/10.1002/14651858.CD006638.pub3.

- Wang X, Ding X, Tong Y, Zong J, Zhao X, Ren H, et al. Ketamine does not increase intracranial pressure compared with opioids: meta-analysis of randomized controlled trials. J Anesth 2014;28:821–7. https://doi.org/10.1007/s00540-014-1845-3.

- Gruenbaum SE, Meng L, Bilotta F. Recent trends in the anesthetic management of craniotomy for supratentorial tumor resection. Curr Opin Anaesthesiol 2016;29:552–7. https://doi.org/10.1097/ACO.0000000000000365.

- Chui J, Mariappan R, Mehta J, Manninen P, Venkatraghavan L. Comparison of propofol and volatile agents for maintenance of anesthesia during elective craniotomy procedures: systematic review and meta-analysis. Can J Anaesth J Can Anesth 2014;61:347–56. https://doi.org/10.1007/s12630-014-0118-9.

- Carella M, Tran G, Bonhomme VL, Franssen C. Influence of Levobupivacaine Regional Scalp Block on Hemodynamic Stability, Intra- and Postoperative Opioid Consumption in Supratentorial Craniotomies: A Randomized Controlled Trial. Anesth Analg 2021;132:500–11. https://doi.org/10.1213/ANE.0000000000005230.

- Dey A, Adinarayanan S, Bidkar PU, Bangera RK, Balasubramaniyan V. Comparison of normal saline and balanced crystalloid (plasmalyte) in patients undergoing elective craniotomy for supratentorial brain tumors: A randomized controlled trial. Neurol India 2018;66:1338–44. https://doi.org/10.4103/0028-3886.241347.

- Gelb AW, Craen RA, Rao GSU, Reddy KRM, Megyesi J, Mohanty B, et al. Does hyperventilation improve operating condition during supratentorial craniotomy? A multicenter randomized crossover trial. Anesth Analg 2008;106:585–94, table of contents. https://doi.org/10.1213/01.ane.0000295804.41688.8a.

- Singla A, Mathew PJ, Jangra K, Gupta SK, Soni SL. A Comparison of Hypertonic Saline and Mannitol on Intraoperative Brain Relaxation in Patients with Raised Intracranial Pressure during Supratentorial Tumors Resection: A Randomized Control Trial. Neurol India 2020;68:141–5. https://doi.org/10.4103/0028-3886.279671.

- Darmawikarta D, Sourour M, Couban R, Kamath S, Reddy KK, Shanthanna H. Opioid-Free Analgesia for Supratentorial Craniotomies: A Systematic Review. Can J Neurol Sci J Can Sci Neurol 2019;46:415–22. https://doi.org/10.1017/cjn.2019.57.

- Ban VS, Bhoja R, McDonagh DL. Multimodal analgesia for craniotomy. Curr Opin Anaesthesiol 2019;32:592–9. https://doi.org/10.1097/ACO.0000000000000766.

- Shimony N, Amit U, Minz B, Grossman R, Dany MA, Gonen L, et al. Perioperative pregabalin for reducing pain, analgesic consumption, and anxiety and enhancing sleep quality in elective neurosurgical patients: a prospective, randomized, double-blind, and controlled clinical study. J Neurosurg 2016;125:1513–22. https://doi.org/10.3171/2015.10.JNS151516.

- Ayrian E, Kaye AD, Varner CL, Guerra C, Vadivelu N, Urman RD, et al. Effects of Anesthetic Management on Early Postoperative Recovery, Hemodynamics and Pain After Supratentorial Craniotomy. J Clin Med Res 2015;7:731–41. https://doi.org/10.14740/jocmr2256w.

- Rhondali O, Genty C, Halle C, Gardellin M, Ollinet C, Oddoux M, et al. Do patients still require admission to an intensive care unit after elective craniotomy for brain surgery? J Neurosurg Anesthesiol 2011;23:118–23. https://doi.org/10.1097/ANA.0b013e318206d5f8.

- Hagan KB, Bhavsar S, Raza SM, Arnold B, Arunkumar R, Dang A, et al. Enhanced recovery after surgery for oncological craniotomies. J Clin Neurosci Off J Neurosurg Soc Australas 2016;24:10–6. https://doi.org/10.1016/j.jocn.2015.08.013.

- Blumrich L, Telles JPM, da Silva SA, Iglesio RF, Teixeira MJ, Figueiredo EG. Routine postoperative computed tomography scan after craniotomy: systematic review and evidence-based recommendations. Neurosurg Rev 2021;44:2523–31. https://doi.org/10.1007/s10143-021-01473-w.

- Latz B, Mordhorst C, Kerz T, Schmidt A, Schneider A, Wisser G, et al. Postoperative nausea and vomiting in patients after craniotomy: incidence and risk factors. J Neurosurg 2011;114:491–6. https://doi.org/10.3171/2010.9.JNS10151.

- Faraoni D, Comes RF, Geerts W, Wiles MD, ESA VTE Guidelines Task Force. European guidelines on perioperative venous thromboembolism prophylaxis: Neurosurgery. Eur J Anaesthesiol 2018;35:90–5. https://doi.org/10.1097/EJA.0000000000000710.

- Torbey MT, editor. Neurocritical Care. 2nd ed. Cambridge University Press; 2019. https://doi.org/10.1017/9781107587908.

- Lin N, Han R, Zhou J, Gelb AW. Mild Sedation Exacerbates or Unmasks Focal Neurologic Dysfunction in Neurosurgical Patients with Supratentorial Brain Mass Lesions in a Drug-specific Manner. Anesthesiology 2016;124:598–607. https://doi.org/10.1097/ALN.0000000000000994.

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Publicado

2023-06-05

Cómo citar

Rodríguez Contreras, R., Vega Salvador, A., Reche Navarro, E., & Estévez Santiago, J. (2023). Anestesia en tumores supratentoriales. Revista Electrónica AnestesiaR, 15(5). https://doi.org/10.30445/rear.v15i5.1145

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Artículos de revisión