Anestezja do zabiegów neuroradiologii interwencyjnej

*Mariusz Czechowski, Ewa Karpel, Małgorzata Wąs, Izabela Duda, Konstancja Grzybowska, Bohdan Seifert

Summary
Background.The management of patients with cerebral haemorrhagic events is changing. The recent introduction of endovascular occlusion of cerebral vessels using detachable coils offers an alternative to craniotomy and surgical clipping of arteriovenous malformations for the prevention of recurrent haemorrhage. The aim of this study was to evaluate two methods of general anaesthesia in regard to their influence on cardiovascular stability that is essential for safe conduct of interventional neuroradiological procedures.
Methods. Forty adult patients, of both sexes, aged 18-74 years, and scheduled for embolisation of cerebral haemangiomas or arteriovenous malformations, were randomly allocated to two groups to receive either total intravenous propofol/fentanyl anaesthesia (P) or sevoflurane/fentanyl inhalation anaesthesia (S). Cis-atracurium was used for muscle relaxation in both groups. Heart rate, non-invasive blood pressure, end-tidal carbon dioxide concentration and pulse oximetry readings were noted before induction (T₀), after induction (T_INT) at 60 (T₁), 120 (T₂), 180 (T₃), 240 (T₄) minutes after induction, and after extubation (T_EX).
Results. Cardiovascular and gas exchange parameters were similar in both groups. The recovery time was insignificantly longer in the sevoflurane group.
Discussion and conclusions. The results indicate that, contrary to some previous reports, both methods provide safe and stable anaesthesia for interventional neuroradiological procedures. Sevoflurane may offer a convenient alternative in cases when TIVA is contraindicated.

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