Anesthesia for neurovascular embolisation from 1997-1999 in Prasat Neurological Institute.

ABSTRACT

BACKGROUND: Embolisation is another treatment of choice in neurovascular abnormalities. We reported anesthetic data as a basis for further research. METHOD: A descriptive retrospective study was performed to evaluate the techniques, drug usage and complications associated with anesthesia in patients who underwent embolisation in the Prasat Neurological Institute within 3 years. RESULTS: There were 108 cases and 213 procedures. The diagnoses were mainly arteriovenous malformation (56.34%) and carotid cavernous sinus fistula (23%). 74.65 per cent received general anesthesia with endotracheal tube, 11.74 per cent received inhalation anesthesia with laryngeal mask airway, 7.04 per cent received inhalation anesthesia with endotracheal tube and 6.57 per cent received total intravenous anesthesia with laryngeal mask airway. The patients were given anesthesia with thiopental (73.24%), propofol (26.76%) intubated with succinyl choline (69.01%), nondepolarizing muscle relaxant (21.13%) and without any muscle relaxant (9.86%) maintained with oxygen and halothane (63.85%), isoflurane (4.23%) and sevoflurane (25.35%). Fentanyl (87.79%), morphine (1.88%), nalbunorphine (0.47%) were given as narcotics and if a muscle relaxant was required, atracurium (64.79%), pancuronium (5.63%), vecuronium (4.23%) were used. The complications were hypotension (7.04%), anaphylaxis (1.88%), arterial vasospasm (0.47%) and hyperglycemia (1.41%). However, there was no significant statistical difference among the anesthetic techniques and those complications. Post-anesthetic complications within 30 minutes included shivering (3.76%) which was statistically related to the duration of the procedure. CONCLUSION: It was concluded that in neurovascular embolisation, there was no need for special techniques or drugs in anesthesia but anesthetic personnel had to optimize the patient's condition for the safety and convenience of neuroradiologists and there should be an awareness of complications eventhough these were not related to anesthetic techniques; further improvement in prevention should be established.