Neurosurgical Anesthesia

Neurosurgical Anesthesia

The division of neurosurgical anesthesiology is an active service performing over 2,200 anesthetics annually. There are currently seven full time anesthesiology attendings associated with this division, headed by Dr. Marc Bloom and Dr. John Ard. Members of this group provide anesthesia in the operating room, neuroradiology, and in MRI and CT suites. Neurosurgical patients often require a neurological exam at the end of a procedure. To meet this challenge, we monitor anesthetic depth using a BIS monitor on most of our patients.

Clinical Case Mix

We perform every type of neurosurgical procedure imaginable. Craniotomies are performed for patients with tumors, vascular lesions, and functional neurological diseases such as epilepsy and movement disorders. NYU Langone Medical Center is an internationally recognized center for computer-assisted stereotactic surgery. These patients often arrive with head frames and require special devices for airway management.

About 90% of patients undergoing craniotomies under general anesthesia require neurophysiologic monitoring. For these procedures, we use intravenous anesthetics and analgesics only (TIVA).

The epilepsy center at NYU Langone Medical Center refers many patients for surgery. While many of these cases are performed under general anesthesia, some are performed as "awake craniotomies", particularly when cerebral areas associated with language are involved.

NYU Langone Medical Center has along tradition as a center for management of patients with cerebral vascular lesions. We provide anesthesia for patients with arteriovenous malformations, cerebral aneurysms, and, occasionally, carotid artery stenosis.

Spine surgery represents another area of excellence. Besides the routine spinal discectomies, we also provide anesthesia for patients having more complicated spinal procedures. About 50% of these procedures involve intraoperative electrophysiologic monitoring. Patients with cervical spine disease require special devices for airway management (fiberoptic scope, intubating LMA, etc.).

Our invasive neuroradiology department is very active. Our neuroradiologists perform procedures primarily for intracerebral or spinal vascular lesions. These include arteriovenous malformations and aneurysms. In addition, vascular lesions involving the periphery are treated. Most of these patients require general anesthesia.

In summary, the division of neurosurgical anesthesiology provides state of the art anesthesia care for a wide variety of neurosurgical and neuroradiological procedures.