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Anesthetic Management of Supratentorial Tumors

The overall annual incidence of primary central nervous system (CNS) tumors was reported by the Central Brain Tumor Registry of the United States as 21.03 per 100,000 during the period between 2006 and 2010. Of the 326,711 reported tumors, the majority (>80%) were supratentorial. Craniotomies for supratentorial tumors (STT) provide unique challenges to both the surgeon and anesthesiologist. The main goals for anesthetic management include the optimization of intracranial pressure (ICP) and maintenance of cerebral perfusion pressure (CPP) to ensure adequate oxygen delivery to the cerebral tissues and avoid secondary insults to the brain. In this review, we will discuss the current literature and key points of intraoperative management.