General anesthesia in patient with Brain Injury


  • Ali Anwar Al-kuraishy Department of Surgery, Al-Karama Hospital, Baghdad Health Department, Karkh, Iraq
  • Husam Jamal Jalil Department of Surgery, Al-Karama Hospital, Baghdad Health Department, Karkh, Iraq
  • Alaa Saleh Mahdi Department of pharmaceutics collage – Pharmacy Department – Al-bayan – University – Baghdad _ Iraq
  • Hany Al-hussaniy Department of pharmacology collage of medicine , University of Baghdad . Iraq



Blood-Brain Barrier, Anesthesia, Intravenous Post-Traumatic, Brain Injuries, Cerebrovascular Circulation, Intracranial Hypertension


The basic concept of Neuroanesthesia & Neuro Critical Care is the ABCDE of neuroanesthesia.
Early Brain Injury (EBI) was formerly known as primary brain injury. In EBI, there is a loss of autoregulation and loss of blood-brain barrier integrity. The presence of Cushing's triad indicates the presence of intracranial hypertension. The target of blood pressure in traumatic brain injury (TBI) is to avoid blood pressure systolic <110 mmHg, maintain cerebral perfusion pressure
(CPP) 60-70 mmHg, target PaCO2 regulation is normocarbia, PaCO2 35–40 mmHg, prophylactic use of phenytoin or valproate is not recommended to prevent late post-traumatic seizures (late PTS).
There is still a need to analyse decompressive craniectomy (DECRA) therapy compared with continued medical treatment for refractory intracranial pressure (ICP) elevations after TBI. General anesthesia for patients with severe TBI is preferable to total intravenous anesthesia (TIVA). The administration of fluids should consider the osmolarity of these fluids. In the new concept, in patients with elevated ICP, the volatile anesthetic concentration should be limited to 0.5 MAC. The target blood sugar is normoglycemia. Prophylactic or therapeutic hypothermia appears to have no place in managing severe brain injury.


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How to Cite

Al-kuraishy, A. A., Jalil, H. J., Mahdi, A. S., & Al-hussaniy, H. (2022). General anesthesia in patient with Brain Injury. Medical and Pharmaceutical Journal, 1(1), 25–34.