CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2021; 08(01): 020-027
DOI: 10.1055/s-0039-1692734
Review Article

Anesthetic Considerations in Cardiac Patients Undergoing Neurosurgery

Rashmi Bhatt
1  Department of Anaesthesia, Aberdeen Royal Infirmary, Aberdeen, Scotland, United Kingdom
Puneet Khanna
2  Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
› Author Affiliations


Elective and emergency neurosurgical procedures pose considerable risk in patients with cardiac disease. As the incidence of cardiac disease has increased in the general population over the past few decades, it is imperative to familiarize oneself with the challenges posed and the recommended management guidelines. The eventual outcome is significantly altered by the nature and severity of the underlying cardiac condition, as is the anesthetic management. A well-optimized cardiac condition can reduce morbidity and mortality considerably, which, however, may not be possible in neurosurgical emergencies. This review aims to look at various pathophysiological implications of cardiac disease, against the background of anesthetic management of neurosurgery. The discussion includes assessment and stratification of risk, appropriate investigations indicated, and the plan of anesthetic management. Even though no specific guidelines have been formulated, the discussion is largely to derive from the guidelines for patients with cardiac disease undergoing noncardiac surgery.

Publication History

Publication Date:
14 July 2019 (online)

© 2020. Indian Society of Neuroanaesthesiology and Critical Care. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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