Introduction: The objectives of neuroanesthesic management should focus on generating unconsciousness, amnesia and antinociception, maintaining cerebral perfusion pressure, control of intracranial pressure, avoiding secondary damage due to hypoxemia, hypo or hypercapnia, hyper or hypoglycemia, to thus being able to provide optimal surgical conditions, allowing in turn early neurological evaluation. Objectives: The present review aims to evaluate in a practical way the main pharmacokinetic models and correlate them with the changes that occur in neurosurgical patients. Methodology: PubMed, Science Direct was searched using intravenous anesthesia, spinal surgery, neurosurgery as search terms. Results: The articles reviewed show that anesthetic management plays a crucial role in providing optimal surgical conditions and at the same time being able to carry out intraoperative neurophysiological monitoring, while allowing early neurological evaluation. Conclusions: Total intravenous anesthesia in neurosurgery implies understanding the changes caused with each of the anesthetic agents and the modifications derived from the neurological pathology, in view of which it is essential to monitor the effect generating minimal impact on the systemic and cerebral hemodynamics in order to provide the same closer today to a "personalized anesthesia"
