open access

Vol 45, No 3 (2013 Jul-Sep)
Original and clinical articles
Submitted: 2013-09-25
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Anaesthetic management for endovascular treatment of unruptured intracranial aneurysms

Zbigniew Karwacki, Małgorzata Witkowska, Seweryn Niewiadomski, Andrzej Wiatr, Paweł Bukowski, Jolanta Wierzchowska, Adam Zapaśnik
DOI: 10.5603/AIT.2013.0030
·
Anaesthesiol Intensive Ther 2013;45(3):145-148.

open access

Vol 45, No 3 (2013 Jul-Sep)
Original and clinical articles
Submitted: 2013-09-25

Abstract

BACKGROUND: Endovascular 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.

METHODS: The study encompassed 26 patients undergoing endovascular treatment of intracranial aneurysms. The mean arterial pressure (MAP), heart rate (HR), bispectral index (BIS), end-tidal CO2(ETCO2) 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.

RESULTS: MAP 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.

CONCLUSIONS: General anaesthesia with propofol and LMA ensures suitable conditions for endovascular treatment of intracranial aneurysms.

Abstract

BACKGROUND: Endovascular 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.

METHODS: The study encompassed 26 patients undergoing endovascular treatment of intracranial aneurysms. The mean arterial pressure (MAP), heart rate (HR), bispectral index (BIS), end-tidal CO2(ETCO2) 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.

RESULTS: MAP 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.

CONCLUSIONS: General anaesthesia with propofol and LMA ensures suitable conditions for endovascular treatment of intracranial aneurysms.

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Keywords

general anaesthesia, intracranial aneurysm; general anaesthesia, interventional neuroradiology; anaesthetics, propofol; artificial airway, laryngeal mask airway

About this article
Title

Anaesthetic management for endovascular treatment of unruptured intracranial aneurysms

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 45, No 3 (2013 Jul-Sep)

Pages

145-148

DOI

10.5603/AIT.2013.0030

Bibliographic record

Anaesthesiol Intensive Ther 2013;45(3):145-148.

Keywords

general anaesthesia
intracranial aneurysm
general anaesthesia
interventional neuroradiology
anaesthetics
propofol
artificial airway
laryngeal mask airway

Authors

Zbigniew Karwacki
Małgorzata Witkowska
Seweryn Niewiadomski
Andrzej Wiatr
Paweł Bukowski
Jolanta Wierzchowska
Adam Zapaśnik

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