Girişimsel Nöroradyolojide Anestezi Yönetimi

Yıl 2019, , 188 - 198, 26.12.2019

Demet Laflı Tunay

https://doi.org/10.36516/jocass.2019.22

Öz

Özet: Görüntüleme tekniklerinin ve teknolojinin ilerlemesi, bir zamanlar açık cerrahi gerektiren bazı yaralanmaların ve tıbbi durumların tedavisinde girişimsel radyoloji işlemlerinin gelişmesine yol açmıştır. Girişimsel nöroradyoloji, endovasküler veya perkütan erişim yoluyla terapötik ilaçlar ve cihazlar yerleştirerek nörovasküler ve bazı nöroşirürjik hastalıkların yönetiminde önemli role sahiptir. Girişimsel nöroradyoloji işlemlerinin karmaşıklığı ve çoğunlukla uzun sürmesi ve sıklıkla önemli komorbiditeleri olan hastaların bu tür işlemlere alınması girişimsel nöroradyoloji alanında anestezi bakımına olan ihtiyacı giderek artırmaktadır. Bu alan aynı zamanda, özel hazırlıklar gerektiren ve ana ameliyathane bölümüne uzakta olan “saha dışı” konumu nedeniyle anestezi bakımında fazladan zorluklar yaratmaktadır. Bu derlemede girişimsel nöroradyolojide anestezi yönetimine değinilmek istenmiştir.

Anahtar kelimeler: Anestezi yönetimi, girişimsel nöroradyoloji,monitörizasyon.

 

Abstract: The advancement of imaging techniques and technology has led to the development of interventional radiology procedures in the treatment of certain injuries and medical conditions that once required open surgery. Interventional neuroradiology has an important role in the management of neurovascular and certain neurosurgical diseases by placing therapeutic drugs and devices through endovascular or percutaneous access. The complexity and often prolonged duration of interventional neuroradiology procedures, and the inclusion of patients with often significant comorbidities, increase the need for anesthesia care in the field of interventional neuroradiology. This area also contributes additional difficulties in anesthesia care due to its ‘’off-site” location, which requires special preparations and its distance from the main operating room. In this review, it is aimed to discuss anesthesia management in interventional neuroradiology.

Key words: Anesthesia management, interventional neuroradiology, monitorisation.

 

Anahtar Kelimeler

Anestezi yönetimi, girişimsel nöroradyoloji, monitörizasyon

Kaynakça

• 1. Varma MK, Price K, Jayakrishnan V, Manickam B, Kessell G. Anaesthetic considerations for interventional neuroradiology. Br J Anaesth. 2007;99(1):75–85. https://doi.org/10.1093/bja/ aem122.
• 2. Boggs SD, Barnett SR, Urman RD. The future of nonoperating room anesthesia in the 21st century. Curr Opin Anaesthesiol. 2017;30:644–51. https://doi.org/10.1097/ ACO.0000000000000528.
• 3. Dabu-Bondoc S. Non operating room anesthesia. Curr Opin Anaesthesiol. 2017;30(6):639–43. https://doi.org/10.1097/ACO.0000000000000524.
• 4. NCEPOD Managing the Flow? A review of the care received by patients who were diagnosed with an aneurysmal subarach- noid haemorrhage, 2013
• 5. Dirringer M. Management of aneurysmal subarachnoid haemorrhage. Crit Care Med 2009; 37: 432–40
• 6. Appleby I, Gregory T. Anaesthesia for interventional neuro- radiology. Anaesth Intensive Care 2010; 11: 366–8
• 7. Varma MK, Price K, Jayakrishnan V, Manickam B, Kessell G. Anaesthetic considerations for interventional neuroradiol- ogy. Br J Anaesth 2007; 99: 75–8
• 8. Luoma A, Reddy U. Acute management of aneurysmal sub- arachnoid haemorrhage. Contin Educ Anaesth Crit Care Pain 2013; 13: 52–8
• 9. Schulenburg E, Matta B. Anaesthesia for interventional neu- roradiology. Curr Opin Anaesthesiol 2011; 24: 426–32
• 10. Molyneux AJ, Kerr RSC, Birks J et al. for the ISAT collaborators. Risk of recurrent subarachnoid haemorrhage death or de- pendence, and standardised mortality ratios after clipping or coiling of an intracranial aneurysm in the International Subarachnoid Aneurysm Trial: longterm follow up. Lancet Neurol 2009; 8: 427–33
• 11. Patel S, Appleby I. Anaesthesia for interventional neurora- diology. Anaesth Intensive Care 2013; 14: 387–90
• 12. Hashimoto T, Gupta DK, Young WL. Interventional neurora- diology—anesthetic considerations. Anesthesiol Clin North Am 2002; 20: 347–59
• 13. ReddyU,SmithM.Anestheticmanagementofendovascular procedures for cerebrovascular atherosclerosis. Curr Opin Anaesthesiol 2012; 25: 486–92
• 14. Lee CZ, Young WL. Anesthesia for endovascular neurosur- gery and interventional neuroradiology. Anesthesiol Clin 2012; 30: 127–47
• 15. Society of Neuroscience in Anesthesiology and Critical Care Expert Consensus statement: anesthetic manage- ment of endovascular treatment of acute ischemic stroke, 2014
• 16. American Society of Anesthesiologists Committee on Standards and Practice Parameters. Statement On Nonoperating Room Anesthetizing Locations. 2013:1–2.
• 17. Perritt E, Mahalingam G. The principles of anaesthesia for neuroradiology: anaesthesia tuto- rial of the week 308. Anaesthesia tutorial of the week. London: WFSA; 2014. p. 1–11.
• 18. Patel S, Reddy U. Anaesthesia for interventional neuroradiology. Br J Anaesth Educ. 2016;16(12):147–52. https://doi.org/10.1093/bjaed/mkv032.
• 19. Kramer AH, Roberts DJ, Zygun DA. Optimal glycemic control in neurocritical care patients: 
a systematic review and meta-analysis. Crit Care. 2012;16(5):R203. https://doi.org/10.1186/ 
cc11812.
• 20. American Society of Anesthesiologists Committee on Standards and Practice Parameters. Standards for basic anesthetic monitoring. 2015:1–4.
• 21. Branston NM, Symon L, Crockard HA, Pasztor E. Relationship between the cortical evoked potential and local cortical blood ow following acute middle cerebral artery occlusion in the baboon. Exp Neurol. 1974;45(2):195–208. https://doi.org/10.1016/0014-4886(74)90112-5.
• 22. Castioni CA, Amadori A, Bilotta F, et al. Italian COnsensus in Neuroradiological 
Anesthesia (ICONA). Minerva Anestesiol. 2017;83(9):956–71. https://doi.org/10.23736/ 
S0375-9393.17.11753-0.
• 23. Guercio JR, Nimjee SM, James ML, McDonagh DL. Anesthesia for interventional neuroradi- ology. Int Anesthesiol Clin. 2015;53(1):87–106. https://doi.org/10.1053/sa.2000.17788.
• 24. Lee CZ, Young WL. Anesthesia for endovascular neurosurgery and interventional neuroradiol- ogy. Anesthesiol Clin. 2012;30:127–47. https://doi.org/10.1016/j.anclin.2012.05.009.
• 25. Kapila A, Glass PSA, Jacobs JR, et al. Measured context-sensitive half-times of remifentanil and alfentanil. Anesthesiology. 1995;83:968–75.
• 26. Boisseau N, Madany M, Staccini P, et al. Comparison of the effects of sevo urane and propo- fol on cortical somatosensory evoked potentials. Br J Anaesth. 2002;88(6):785–9. https://doi. org/10.1093/bja/88.6.785.
• 27. Malcharek MJ, Loef er S, Schiefer D, et al. Transcranial motor evoked potentials during anes- thesia with des urane versus propofol - a prospective randomized trial. Clin Neurophysiol. 2015;126(9):1825–32. https://doi.org/10.1016/j.clinph.2014.11.025.
• 28. Castagnini HE, van Eijs F, Salevsky FC, Nathanson MH. Sevo urane for interventional neuro- radiology procedures is associated with more rapid early recovery than propofol. Can J Anesth. 2004;51(5):486–91. https://doi.org/10.1007/BF03018313.