[The effect of intraoperative continuous nimodipine infusion on cerebral vasospasm during intracranial aneurysm surgery].
OBJECTIVE
To evaluate the effect of intraoperative continuous nimodipine infusion on cerebral vasospasm during intracranial aneurysm surgery.


METHODS
Thirty consecutive patients under-going intracranial aneurysmal surgery were prospectively randomized into two groups: Isoflurane (group A, n = 15) and nimodipine (group B, n = 15). The patients in group A were maintained with 1 minimum alveolar concentration (MAC) isoflurane anesthesia during the whole procedure. The patients in group B were given nimodipine infusion continuously (20 microg.kg(-1).h(-1)) after induction of anesthesia and anesthetized with 1 MAC isoflurane. S100B levels in cerebrospinal fluid were determined before aneurysm clipping and 0, 2, 4 h after aneurysm clipping by enzyme linked immunosorbent assay. Assessment of mean blood flow velocity of parent arterial and arterial branches were performed before and after aneurysm clipping.


RESULTS
(1) S100B in cerebrospinal fluid was increased significantly at 4 h after aneurysm was clipped in group A (F = 4.11, P < 0.05). However, S100B in cerebrospinal fluid was stable in group B in the whole procedure. (2) Mean arterial flow velocity of parent vessels in group B was lower significantly than that in group A (t = 2.08, P < 0.05). However, mean arterial flow velocity of distal vessels in both groups has no significant difference.


CONCLUSIONS
Intraoperative nimodipine infusion may prevent cerebral vasospasm during intracranial aneurysm surgery.
Han
Ru-quan
RQ
Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
Wang
Bao-guo
BG
Li
Shu-ren
SR
Wang
En-zhen
EZ
Liu
Wei
W
Wang
Shuo
S
Zhao
Ji-zong
JZ
D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D007431:Intraoperative Complications / Q000517:prevention & control; D007530:Isoflurane / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009553:Nimodipine / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000627:therapeutic use*; D020301:Vasospasm, Intracranial / Q000517:prevention & control*
D018686:Anesthetics, Intravenous; D014665:Vasodilator Agents; D009553:Nimodipine; D007530:Isoflurane