Spectrum Healthcare Partners’ anesthesiology team plays a vital role in neurosurgery, where every second and every signal matters.
“Neurosurgical procedures often involve incredibly delicate work near the brain or spinal cord,” says Parker Merrill, MD, Spectrum anesthesiologist and division director of neuro-anesthesiology at Spectrum. “As anesthesiologists, our job is to create a safe, stable environment that protects those structures while helping the surgeon do their best work – and new technologies are helping us do that better than ever.”
Expertise for the Most Delicate Surgeries
At MaineHealth Maine Medical Center Portland, Spectrum anesthesiologists support a wide variety of brain and spine procedures. More common surgeries include things like lumbar microdiscectomies (a minimally invasive procedure to remove the herniated portion of spinal disc) and spinal fusions. At the more highly complex end of the range are cases such as pituitary adenomas (non-cancerous tumors on the pituitary gland, located at the base of the brain), cerebral aneurysm clippings (a microsurgery to close off a weak, bulging spot in a brain artery using a metal clip), and spinal cord tumors.
“Working near the brain or spinal cord requires careful planning and technique,” says Dr. Merrill. “And it’s often complicated by the fact that many of these cases are emergent.”
Among the most intricate is the awake craniotomy – brain surgery performed while the patient is awake – typically required when a tumor is near critical speech or motor centers. During surgery, a speech pathologist may help assess patient responses in real time, guiding the surgeon to preserve healthy brain tissue.
“These procedures demand extreme precision and seamless coordination between the surgical and anesthesia teams,” Dr. Merrill says. “But this is what we do – and we’re proud to offer this level of care here in Maine.”
Advancements for Better Patient Care
In today’s OR, one of the most important advances is real-time neuromonitoring – a technique that tracks brain and nerve activity during surgery and immediately alerts the team to changes.
“It’s a true team effort,” says Dr. Merrill. “If something changes, everyone – the surgeon, anesthesiologist, technologist, and neurologist – is alerted in real time so we can respond right away. That kind of coordination has a huge positive impact on patient outcomes.”
Real-time EEG monitoring adds another layer of personalized care. It allows the anesthesia team to fine-tune medications based on how the patient’s brain is responding – minute by minute.
“Being able to adjust anesthesia in the moment has been a game changer,” says Dr. Merrill. “It’s had a major impact on the safety and success of many neurosurgical procedures.”
In these cases, anesthesiologists also use a unique set of medications – including drugs that reduce brain swelling, preserve cerebral blood flow, and prevent seizures – all continuously adjusted based on what’s happening in the OR.
Collaboration at Every Step
Delivering high-volume, high-complexity care takes a team that’s handled it countless times – and knows how to adapt the moment things change.
“Having a dedicated anesthesia team that handles neurosurgical cases every day makes a real difference for patients,” says Dr. Merrill. “We see such a wide variety of cases at MaineHealth Maine Medical Center Portland, and that experience gives us the confidence and skill to tackle any neurologic pathology – no matter how complex.”
Every case begins with a collaborative plan, where surgical and anesthesia teams review patient details together to prepare for any potential complications that may arise.
That collaboration continues in the OR, where residents and CRNAs are essential members of the care team. “They’re the constant presence at the patient’s side,” says Dr. Merrill.
“They’re often the first to notice any changes and the first to respond. They’re truly the front line of patient safety.”
Innovation Always Begins with Patient Care
“Now more than ever, we’re able to help patients with a huge variety of medical and surgical challenges,” says Dr. Merrill. “Everything we do is about keeping patients safe and comfortable during surgery so they can recover well – and get back to what they love most.”
For Dr. Merrill, innovation also means advancing the field. “Spectrum has given me the chance to not only care for patients but also help drive research and system improvements that raise the bar for everyone,” he says. “As a group, we’re always looking for ways to make care safer, smarter, and more personalized for people here in Maine.”
