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Anaesthesiol Intensive Ther · Jul 2013
Anaesthetic management for endovascular treatment of unruptured intracranial aneurysms.
- Zbigniew Karwacki, Małgorzata Witkowska, Seweryn Niewiadomski, Andrzej Wiatr, Paweł Bukowski, Jolanta Wierzchowska, and Adam Zapaśnik.
- Department of Neuroanaesthesiology, Medical University of Gdańsk, Poland. zkarw@gumed.edu.pl.
- Anaesthesiol Intensive Ther. 2013 Jul 1; 45 (3): 145-8.
BackgroundEndovascular techniques for treatment of intracranial aneurysms are increasingly commonly applied. In general, the procedures are short, require general anaesthesia and complete immobilisation of patients. The aim of the present study was to assess the usefulness of general anaesthesia with propofol and laryngeal mask airway for endovascular management of intracranial aneurysms based on analysis of haemodynamic stability.MethodsThe study encompassed 26 patients undergoing endovascular treatment of intracranial aneurysms. The mean arterial pressure (MAP), heart rate (HR), bispectral index (BIS), end-tidal CO₂(E(T)CO₂) and haemoglobin saturation with oxygen (SpO₂ ) were determined at eight measurement points: T₁ - before anaesthesia induction, T₂ - after induction, T₃ - after LMA insertion, T₄ - during arteriography, T₅ - during "coiling" , T₆ - at completion of propofol infusion, T₇ - before LMA removal, T₈ - after LMA removal.ResultsMAP and HR were found significantly reduced between T₂ and T₁ . To maintain BIS within the range of 40-60, the following propofol infusion rates (in mg kg b.w.⁻¹ h⁻¹ ) were required: T₂ - 4.5 ± 0.3; T₃ - 4.6 ± 0.7; T₄ - 4.5 ± 0.8 and T₅ - 4.4 ± 0.6. E T CO₂ and SpO₂ were not demonstrated to be changed. The mean duration of anaesthesia and of recovery was 64.3 ± 21.8 and 8.9 ± 4.8 min, respectively.ConclusionsGeneral anaesthesia with propofol and LMA ensures suitable conditions for endovascular treatment of intracranial aneurysms.
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