Neuroanesthetic management for surgical clipping of a ruptured cerebral aneurysm: clinical practice guidelines
Ingelmo Ingelmo, I.; Carmona Aurioles, J.; Rama-Maceiras, P.; Fàbregas Julià, N.; Hernández-Palazón, J.
Revista Espanola de Anestesiologia y Reanimacion 57 Suppl. 2: S16-S32
2010
ISSN/ISBN: 0034-9356 PMID: 21298907 Document Number: 642774
Subarachnoid hemorrhage due to spontaneous rupture of a cerebral aneurysm is associated with high rates of morbidity and mortality and requires multidisciplinary treatment. The debate on surgical vs endovascular treatment continues, although short-term clinical outcomes and survival rates are better after endovascular treatment. In Spain, a strong trend toward reduced use of clipping has been noted, and neuroanesthetists are less often called on to provide anesthesia in this setting. Our intervention, however, can be decisive. The neuroscience working group of the Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor has developed guidelines for managing anesthesia in these procedures. Based on a national survey and a systematic review of the literature, the recommendations emphasize the importance of ensuring appropriate intracranial conditions, treating complications, and taking steps to protect against cerebral hemorrhage.