ABSTRACT
This chapter describes the investigations, premedication, intravenous access and monitors of the supratentorial tumor. It also describes the induction, intravenous fluids, reversal or elective mechanical ventilation and postoperative analgesia of the supratentorial tumor. The chapter discusses the goals of anesthesia to facilitate smooth and rapid induction of anesthesia, to prevent rise in intracranial pressure or brain edema, to maintain cerebral homeostasis with adequate cerebral perfusion pressure, to maintain hemodynamic stability and to facilitate smooth and rapid emergence from anesthesia to enable early neurological assessment. It focuses on the drugs like mannitol, hypertonic saline, phenytoin, furosemide, vasopressors and antiemetics. The chapter explains the intraoperative concerns like intraoperative tense brain, risk of massive blood loss leading to coagulopathy, risk of hemodynamic instability following large fluid shift and blood loss and risk of venous air embolism. It also focuses on the postoperative concerns like pain and postoperative nausea and vomiting (PONV), abnormal coagulation profile following major blood loss, pneumocephalus and seizures.
