Anesthesia in neurovascular diseases
DOI:
https://doi.org/10.52428/20756208.v12i31.505Keywords:
Neurovascular disease, Anesthesia, Surgical anesthetic riskAbstract
The neurovascular diseases are entities of genetic origin and with triggers such as arterial hypertension, smoking, alcoholism, diabetes mellitus, dyslipidemia among others. The most frequent neurovascular pathology is cerebral aneurysm and very rarely arteriovenous malformations.
The rupture of a cerebral aneurysm has a very high mortality at the moment of the rupture and those who survive have a high incidence of physical and socio-economic consequences for the patient and family members. The adequate anesthetic management can influence in improving the perioperative survival of these patients. Perioperative anesthetic monitoring includes sp02, expired C02 (etC02), ECG, noninvasive blood pressure (NIBP), neuromuscular relaxation monitoring, diuresis, invasive blood pressure (IAP), central venous catheter and central venous pressure. Anesthesia is based on a combination ofanesthetics (what is known as balanced genera/ anesthesia), although currently it is advisable to use a technique called Total Intravenous Anesthesia (TIVA) based exclusively on the administration of intravenous anesthetic agents such as propofol or thiopental sodium (hypnotic), remifentanyl or fentanyl (opiode) and atracurium or cisatracurium or rocuronium (muscle relaxant), administered in infusion pumps (manual or TCI) and orotracheal intubation.
The most important objectives are to maintain hemodynamic stability and adequate cerebral relaxation, as well as to facilitate adequate surgical exposure, rapid postoperative reczovery ifappropriate, or to pass the patient asleep and intubated to the intensive care unit in more complicated cases.
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Copyright (c) 2017 Germán David Artunduaga Antezana y Ruth Vanesa Barrientos Medina
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