Outcomes in neuroanesthesia: What matters most?

The goal of this narrative review is to consider and categorize the clinically relevant outcomes that have been previously investigated in neuroanesthesia and to propose the essential outcomes and directions that deserve priority in clinical care and future outcome-oriented research. The current body of neuroanesthesia research has created an important and comprehensive fundamental knowledge base by defining the effect of anesthetic care on various outcomes. The translation of animal data to patients has been limited, however, and must be done cautiously. The literature to date has focused on short-term perioperative outcomes but should now shift towards understanding the role of the neuroanesthesiologist in long-term and disease-specific outcomes that are of great concern to patients. In addition, the term "neurologic outcome" is nonspecific and deserves a better definition, possibly through the integration of multiple scales and measurements. Future endeavours in neuroanesthesia research should advocate prospective randomized trials that focus on long-term neurologic outcomes. These initiatives will require coordination of multiple centres through a clinical trials network.