Evaluation of anesthesia applications in interventional neuroradiology cases

Yıl 2012, , 493 - 499, 01.12.2012

Ziya Kaya Serkan Karaman Mustafa Süren Semih Arıcı Serkan Doğru Mürsel Kahveci

https://doi.org/10.5799/ahinjs.01.2012.04.0208

Öz

Objectives: In this study, we aimed to evaluate anesthesia applications of the patients underwent invasive interventional neuroradiology applications. Materials and methods: Between June 2004 and October 2004, 152 emergency or elective adult patients who were undergone general anesthesia were evaluated retrospectively. Information about the patients was taken from radiology, anesthesia notes and university\'s information system. Patients were evaluated in terms of age, gender, American Society of Anesthesiologists score, indication of application, the existence of concomitant diseases, anesthesia technique, anesthetic medications and the possibility of whether patient were in intensive care unit. Results: Of all, 55.3% of the patients (n=84) were female and 44,7% (n=68) were male. General anesthesia was applied in all cases and propofol was preferred mostly in induction and sevoflurane was preferred in maintenance. Surgically, 81,6% of the patients was elective and 18,4% was emergency patients. Diagnoses of patients were as follow: Cerebral aneurysm 63,8%, arteriovenous malformation 19,7%, thrombolytic therapy 8%, tumor embolization 5,3% and carotid stenting 3,2%. Totally 58 patients were taken into intensive care unit and 6 of these died. Conclusions: In order to provide a safe and efficient patient care, we think that permanent anesthesia equipment is necessary together with good physical conditions of the operation room, proficiency of neuroradiologist, the close relationship between the patient and anesthetist and a good knowledge of underlying neuropathology.

Anahtar Kelimeler

Interventional radiology, general anesthesia, cerebral aneurysm, arterio-venous malformations.

Girişimsel nöroradyoloji olgularında anestezi uygulamalarının değerlendirilmesi

Öz

Amaç: Bu çalışmada, genel anestezi altında invaziv girişimsel nöroradyoloji uygulanan hastaların incelenmesi amaçlanmıştır. Gereç ve yöntem: Temmuz 2004 ve Kasım 2011 tarihleri arasında acil ya da elektif şartlarda radyoloji ünitesinde genel anestezi altında girişim yapılan toplam 152 erişkin hasta retrospektif olarak değerlendirildi. Hastalara ait bilgiler tutulan anestezi fişlerinden, radyoloji notlarından ve üniversitemiz bilgi sisteminden elde edildi. Hastalar yaş, cinsiyet, Amerikan Anestezistler Birliği skoru, girişim endikasyonu, ek hastalık olup olmadığı, kullanılan anestezi tekniği, anestezik ilaçlar ve yoğun bakım ünitesine yatırılanlar olarak incelenip değerlendirildi. Bulgular: Hastaların %55,3\'ü (n=84) kadın ve %44,7\'si de (n=68) erkeklerden oluşmaktaydı. Olguların tamamına genel anestezi uygulanmış olup indüksiyonda en fazla propofol, idamede ise sevofluran tercih edilmiştir. Hastaların %81,6\'sı elektif, %18,4\'ü acil alınmış olup olguların tanıları serebral anevrizma (%63,8), arteriovenöz malformasyon (%19,7), Trombolitik tedavi (%8), tümör embolizasyonu (5,3) ve karotis stenti (%3,2) şeklindeydi. Toplam 58 hasta yoğun bakım ünitesine yatırılmış olup altı tanesi kaybedilmiştir. Sonuç: Güvenli ve etkili hasta bakımının sağlanabilmesi için; altta yatan nöropatolojinin iyi bilinmesi, operasyon odasının fiziki şartları, nöroradyolog, hasta ve anestezist arasındaki yakın ilişki kadar kalıcı anestezi ekiplerinin de gerekli olduğunu düşünmekteyiz.

Anahtar Kelimeler

Girişimsel radyoloji, genel anestezi, serebral anevrizma, arteriovenöz malformasyonlar

Kaynakça

• Schulenburg E, Matta B. Anaesthesia for interven- tional neuroradiology. Curr Opin Anaesthesiol 2011; 24(4):426-32.
• Varma MK, Price K, Jayakrishnan V, Manickam B, Kes- sell G. Anaesthetic considerations for interventional neuroradiology. Br J Anaesth 2007;99(1):75-85.
• Van de Velde M. Interventional neuroradiology. Curr Opin Anaesthesiol. 2003;16(4):417-20.
• Ahmed A. Anaesthesia for interventional neuroradiol- ogy. J Ayub Med Coll Abbottabad 2007;19(3):80-4.
• Van De Velde M, Kuypers M, Teunkens A, Devroe S. Risk and safety of anesthesia outside the operating room. Minerva Anestesiol 2009;75(5):345-8.
• Nadjat-Haiem C, Ziv K, Osborn I. Anesthesia for ca- rotid and cerebrovascular procedures in interventional neuroradiology. Int Anesthesiol Clin 2009;47(2):29-43.
• Münte S, Münte TF, Kuche H, et al. General anesthesia for interventional neuroradiology: propofol versus iso- flurane. J Clin Anesth 2001;13(3):186-92.
• Gregory T, Appleby I. Anaesthesia for interven- tional neuroradiology. Anaesth Intens Care Med 2010;11(9):366-8.
• Newton MC. Anaesthesia for neuroimaging and inter- ventional neuroradiology. Anaesth Inten Care Med 2007:8(10):423-6.
• Krayer S. Anaesthesia for interventional neuroradiol- ogy. Curr Opin Anaesthesiol 2000;13(4):421-7.
• Derbent A, Oran I, Parildar M, Yurtseven T, Uyar M, Memiş A. Adverse effects of anesthesia in interven- tional radiology. Diagn Interv Radiol 2005;11(2):109- 12.
• Lai YC, Bulusu R, Manninen PH. Anesthesia for in- terventional neuroradiology: General considerations. J Crit Care 2000;19(4):248-53.
• Brekenfeld C, Mattle HP, Schroth G. General is bet- ter than local anesthesia during endovascular proce- dures. 2010;41(11):2716-7.
• Jones M, Leslie K, Mitchell P. Anaesthesia for endo- vascular treatment of cerebral aneurysms. J Clin Neu- rosci. 2004;11(5):468-70.
• Osborn IP. Anesthetic considerations for interventional neuroradiology. Int Anesthesiol Clin 2003;41(2):69-77.
• Hashimoto T, Gupta DK, Young WL. Interventional neuroradiology - anesthetic considerations. Anesthe- siol Clin North Am 2002;20(2):347-59.
• See JJ, Manninen PH. Anesthesia for neuroradiology. Curr Opin Anaesthesiol 2005;18(4):437-41.
• Castagnini HE, van Eijs F, Salevsky FC, Nathanson MH. Sevoflurane for interventional neuroradiology procedures is associated with more rapid early recov- ery than propofol. Can J Anaesth 2004;51(5):486-91.
• Doerfler A, Becker W, Wanke I, Goericke S, Forsting M. Endovascular treatment of cerebrovascular dis- ease. Curr Opin Neurol 2004;17(4):481-7.
• Mlekusch W, Schillinger M, Sabeti S. et al. Hypo- tension and bradycardia after elective carotid stent- ing: frequency and risk factors. J Endovasc Ther 2003;10(5):851-9.
• Nagata S, Kazekawa K, Aikawa H, et al. Hemodynam- ic stability under general anesthesia in carotid artery stenting. Radiat Med 2005;23(6):427-31.