Secrets of anesthesia for interventional neuroradiology
Özet
Neuroradiology procedures are being applied more with increasing frequency both for diagnosis and treatment of extra- and intracranial pathologies. In this review, we aimed to determine the most important aspects of anesthesia during interventional neuroradiology. General anesthesia is advantageous in terms of assuring patients' immobility, hemodynamic and respiratory stability. However, nitrous oxide should be preferably avoided as it has the risk to enlarge the micro air bubbles that ingenerate during injection of contrast or irrigation fluid. Bradyarrhythmias may occur during balloon inflation for extracranial carotid angioplasty or stenting. As manipulation of airway may be difficult during the procedure, it is essential to assess the airway during the preoperative visit. Necessary precautions should be taken against seizures, postoperative pain, massive hemorrhage, hypothermia or contrast-induced nephropathy. Hyperactivity of the sympathetic system after subarachnoid hemorrhage and massive catecholamine release may cause critical ECG changes, arrhythmias, and left ventricular failure. Nausea and vomiting may be observed in patients as side-effects of the applied contrast agents and anesthetics. Patients requiring interventional neuroradiology may be transferred directly from the intensive care unit, and the safe transfer is crucial for such patients.
