Abstract
Interventional neuroradiology poses unique challenges to the anesthesiologist. It is frequently in a location remote from the operating room platform, and off-hour emergency cases require the services of more than a core group of anesthesia providers. Fundamental principles include (1) direct communication between the anesthesiologist and neurointerventionalist regarding specifics of the planned procedure, hemodynamic parameters, and preferences regarding general anesthesia (GA) vs. conscious sedation (CS), (2) awareness of the extreme urgency of acute stroke interventions in particular (avoiding time delay and hypotension), (3) avoidance of nitrous oxide due to the procedural risk of cerebral air embolism, (4) use of short-acting anesthetic agents to allow timely emergence and postoperative neurologic examination, and (5) individualized hemodynamic control following anesthetic emergence.
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Nguyen, H.G., Barden, C.B., McDonagh, D.L. (2020). Procedural Challenges in Interventional Neuroradiology. In: Brambrink, A., Kirsch, J. (eds) Essentials of Neurosurgical Anesthesia & Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-030-17410-1_72
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