Pioneer craniotomy at Babcock University Teaching Hospital: Anaesthetic management

Abstract

Glioblastoma multiforme is the highest grade glial tumour and most common in the astrocytic line. This usually requires craniotomy for tumour biopsy, relief of intracranial pressure and reduction in tumour mass as much as possible. In the anaesthetic management of patient for craniotomy, emphasis should be on the provision of safe and optimal preoperative conditions, preservation of neurocognitive functions and a rapid high quality recovery. Maintenance of adequate cerebral perfusion pressure (CPP), normal intra-cranial pressure (ICP) and cerebral oxygenation (CMRO2) is the mainstay of neuro-anaesthesia and requires a thorough understanding of the physiology of the central nervous system (CNS). We report a case of a 59 year old man with glioblastoma multiforme and features of raised intracranial pressure that successfully underwent craniotomy and decompression of the tumour.