ABSTRACT
This chapter describes the preoperative assessment, premedication, intravenous access and monitors of the moyamoya disease. It also describes the induction, intravenous fluids, hemodynamic control and temperature monitoring of the moyamoya disease. The chapter discusses the goals of anesthesia to avoid brain ischemia, to understand the effect of hyper-ventilation: moyamoya vessels overreact from hyperventilation, to understand the detrimental effect of hypocapnia and hypercapnia and to maintain perfusion of stenotic brain vessels by maintaining normovolemia. A short-acting benzodiazepine such as midazolam may be beneficial to avoid hyperventilation from crying and anxiety. The chapter also discusses the standard anesthesia monitors include electrocardiogram (ECG), noninvasive blood pressure (NIBP), pulse oximetry (SpO2), end-tidal carbon dioxide (ETCO2), arterial line for continuous blood pressure monitoring, urine output, and core temperature. Crystalloids and blood and blood products are used as required for maintenance and blood loss replacement.
