摘要篇首： Neurosurgery especially intracranial surgery is characterized by periods of intense stimulation alternating with periods of minimal pain.Manipulation of the brain itself is not painful to the patient, but the scalp, skull, and meninges are well innervated with pain fibers. Traction on cerebral arteries as well as sensory cranial nerves can be painful. Therefore, the most appropriate choice of drugs or measures for neuroanesthesia should be dependent on a clear understanding of the pharmacological effects of anesthetics as well as the requirements for anesthesia/analgesia in general and the individual neurosurgical case. Besides, the ultimate aim of neuroanesthesia is to provide optimal intracranial operating conditions, maintain an appropriate cerebral hemodynamics to ensure enough cerebral perfusion, protect against ischemic insults and prevent postoperative complications. The anesthetic techniques and the anesthetics used in neuroanesthesia are all geared to these objectives.The changes of neuroanesthesia that have occurred in the past decades show a steady evolution of anesthetic care both in the operating room and the neurocritical care setting.