Korean J Anesthesiol.  2020 Feb;73(1):3-7. 10.4097/kja.19272.

Anesthesia for the patient with a recently diagnosed concussion: think about the brain!

Affiliations
  • 1Department of Anesthesiology, Duke University School of Medicine Durham, NC, USA
  • 2Rothman Orthopaedics, Philadelphia, PA, USA
  • 3Department of Family and Community Medicine, Sidney Kimmel Medical College at Thomas Jefferson University Philadelphia, PA, USA
  • 4Department of Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA

Abstract

Some patients require emergent, urgent, or elective surgery in the time period immediately following diagnosis of concussion. However, changes in brain homeostatic mechanisms following a concussion and concern for secondary brain injury can complicate the decision as to whether or not a surgery should proceed or be postponed. Given the paucity of available evidence, further evaluation of the use of anesthesia in a patient with concussion is warranted. This article summarizes what is currently known about the relevant pathophysiology of concussion, intraoperative anesthesia considerations, and effects of anesthesia on concussion outcomes in an attempt to help providers understand the risks that may accompany surgery and anesthesia in this patient population. While most contraindications to the use of anesthesia in concussed patients are relative, there are nonetheless pathophysiologic changes associated with a concussion that can increase risk of its use. Understanding these changes and anesthetic implications can help providers optimize outcomes in this patient population.

Keyword

Brain concussion; Cerebral ischemia; General anesthesia; Intracranial hypotension; Post-concussion syndrome

Cited by  1 articles

Anesthetic management of the traumatic brain injury patients undergoing non-neurosurgery
Hyunjee Kim
Anesth Pain Med. 2023;18(2):104-113.    doi: 10.17085/apm.23017.

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