Anesthesia in Glioma Surgery: Future Prospects

Gözde İNANa, Başak Ceyda MEÇOb

aGazi University Faculty of Medicine, Department of Anesthesiology and Reanimation, Ankara, Türkiye
bAnkara University Faculty of Medicine, Department of Anesthesiology and Reanimation, Ankara, Türkiye

İnan G, Meço BC. Anesthesia in glioma surgery: Future prospects. In: Uğur HÇ, Bayatlı E, eds. Glial Tumours: Expectations from Today-Promises of the Future. 1st ed. Ankara: Türkiye Klinikleri; 2024. p.83-9.

ABSTRACT

Brain cancer is one of the leading cause of diseases globally. Gliomas are malignant transforma- tions of glial cells in the brain that have a high level of malignancy and a low survival rate. Since disease pro- gression is the primary cause of death in glioma patients, a significant amount of research has been conducted to better understand the mechanisms and risk factors that contribute to tumor development following surgery and to improve patient outcomes. Any surgical procedure requires anesthesia to protect the patient’s safety and comfort. This is especially noticeable during glioma procedures because the brain’s fragility necessitates extra care. The goal of anesthesia in recent years has been defined as an anesthetic technique with an ethical and tai- lored approach to each patient based on their needs. In modern anesthetic practice, the idea of patient-centered precision care medicine which stresses individualized care, anticipating possible side effects, and the need for precise monitoring is gaining popularity. The anesthetic management of glioma cases is challenging, involving careful balance of numerous elements, such as brain preservation, focusing on the prognosis of the primary pathology, and maintaining positive patient-reported results. Glioma resection surgery can be performed under both volatile-based general anesthesia and total intravenous anesthesia (TIVA). The long-term result may be af- fected by the anesthetic techniques affecting the patients’ neurofunction and systemic state. Moreover, a vari- ety of intraoperative variables and interventions, such as anesthesia techniques, may have detrimental effects on oncological outcomes. Recent study has focused on the role of anesthetics in cancer growth, although the re- sults are inconsistent. As this field of study is still in its early stages, it is yet unknown how anesthesia affects the development of gliomas. More research is required on this important topic. The goal of this review is to em- phasize the concept of patient-centered precision care anesthesia in the preoperative period, as well as to dis- cuss the potential effects of anesthetics on tumor prognosis and patient outcomes in glioma surgery.

Keywords: Glioma; anesthesia; neurosurgical procedures; precision anesthesia; patient reported outcome measures; treatment outcome

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