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Anesthesia for interventional neuroradiology
P H Manninen1, E M Gignac, A W Gelb
1Department of Anaesthesia, University Hospital, London, Ontario, Canada.
Study Objective:
To review the anesthetic management and the occurrence and treatment of complications in patients undergoing interventional neuroradiologic procedures for the treatment of intracranial vascular lesions.
Design:
Retrospective chart review of 115 charts from 1988 to 1992.
Setting:
University hospital.
Measurements And Main Results:
Charts were reviewed for information regarding the anesthetic management, monitoring techniques, complications, treatment of complications, and clinical outcome. Group 1 patients (n = 92) were managed by an anesthesiologist; 8 received general anesthesia and 84 had conscious sedation. Group 2 patients (n = 70) were cared for by a neuroradiologist; 37 received intravenous analgesia (fentanyl) and 33 received no sedation other than premedication (benzodiazepine). No episodes of anesthetic or drug-related complications were documented. Complications directly related to technical aspects of the procedure were documented in 33 (20%) cases, 19 (21%) in Group 1 and 14 (20%) in Group 2. These complications consisted of ischemia (n = 14), hemorrhage (n = 9), catheter misplacement (n = 8), and pulmonary embolism (n = 2). Four patients, two in each group, required urgent assessment by an anesthesiologist.
Conclusions:
There was no difference in the incidence of complications between the two groups. As the use of interventional neuroradiology increases, the anesthesiologist will be more involved in the elective or emergency treatment of these patients.