Anesthetic management for clipping a giant basilar artery aneurysm with moderate hypothermia, extracorporeal circulation assistance, and propofol infusion.
A 65-year-old female patient underwent surgery to clip a giant basilar artery aneurysm with closed-chest extracorporeal circulation using femorofemoral bypass. Moderate hypothermia (27 degrees C-30 degrees C), retention of spontaneous circulation, and propofol infusion (3-5 mg. kg(-1). h(-1)) were used under general anesthesia. Blood outflow via femoral vein was sufficient to maintain cardiopulmonary bypass and to induce hypothermia. Hemodynamics were controlled with dopamine and noradrenaline. In this case, extracorporeal circulation under moderate hypothermia was used to assist rather than substitute for spontaneous circulation, and spontaneous circulation was maintained at all times. We think that this method had advantages over deep hypothermic circulatory arrest with regard to intraoperative risks and postoperative complications.
Yamada
Makiko
M
Department of Anesthesiology, Gunma University Graduate School of Medicine, Maebashi City, Japan.
Nishikawa
Koichi
K
Kawahara
Fuminori
F
Yoshikawa
Daisuke
D
Saito
Shigeru
S
Goto
Fumio
F
D000368:Aged; D000768:Anesthesia, General; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D005112:Extracorporeal Circulation; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D007262:Infusions, Intravenous; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D015742:Propofol / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
D018686:Anesthetics, Intravenous; D015742:Propofol