Anestesia Intravenosa Total (TIVA) em Neurocirurgias: Um Novo Padrão de Cuidado
DOI:
https://doi.org/10.34119/bjhrv8n5-257Keywords:
anestesia intravenosa total, neurocirurgia, neuroproteçãoAbstract
A anestesia intravenosa total (TIVA) tem se destacado como uma técnica anestésica avançada em neurocirurgias, oferecendo benefícios substanciais em termos de estabilidade hemodinâmica, controle da pressão intracraniana (PIC), neuroproteção e recuperação pós-operatória. Este artigo apresenta uma revisão narrativa da literatura sobre os fundamentos farmacológicos, benefícios, desafios e perspectivas futuras da TIVA em procedimentos neurocirúrgicos. Entre os agentes utilizados, o propofol, remifentanil e dexmedetomidina desempenham papéis centrais, atuando de maneira sinérgica para modular o metabolismo cerebral, controlar respostas autonômicas e promover estabilidade hemodinâmica. As evidências recentes apontam para menor interferência nos registros neurofisiológicos intraoperatórios e redução de complicações cognitivas no período pós-operatório, especialmente em populações vulneráveis. Entretanto, a TIVA apresenta desafios relacionados ao monitoramento avançado, custo operacional e necessidade de protocolos personalizados, destacando a importância do treinamento especializado e da tecnologia na sua aplicação. Pesquisas emergentes sugerem avanços promissores, incluindo o uso de biomarcadores intraoperatórios e sistemas de administração controlados por inteligência artificial, que podem aprimorar ainda mais a precisão e segurança dessa técnica. Este estudo conclui que a TIVA representa uma abordagem anestésica de grande impacto em neurocirurgias, alinhada às demandas de intervenções complexas e à busca por desfechos mais seguros e favoráveis.
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