title: [Anesthetic practices and use of brain protective therapies for cerebral aneurysm surgery in Japan].
abstract: We surveyed anesthetic practices and the use of cerebral monitoring and brain protective therapies during cerebral aneurysm surgery by sending a questionnaire to 822 hospitals in Japan. Three hundred and fifty four hospitals responded. For induction, 51% used thiopental, 41% used propofol, and 94% supplemented induction with fentanyl. For maintenance 45% used isoflurane, 29% used sevoflurane, and 26% used propofol. Only 6% used EEG and/or evoked potentials in most of their patients. Specific brain protective measures were used in most of the hospitals. If used, 97% used mannitol, 43% used steroids and 23% used a certain level of induced hypothermia. When mild hypothermia was used, 39% used 33-34 degrees C, 59% used>34 degrees C, 2% used <33 degrees C, and only 4% used mild hypothermia in every patient. During temporary clipping, 18% kept the blood pressure equal to the level when awake, while 56% used induced hypotension. To control blood pressure during extubation, 72% used nicardipine or nitroglycerine. The use of intraoperative brain protective therapies were common but brain monitoring was not the standard.
authors.affiliation: Division of Anesthesia and Critical Care Medicine, Southern Tohoku Research Institute for Neuroscience, Koriyama 963-8563.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Kan
authors.forename: Hisashi
authors.initials: H
authors.lastname: Hattori
authors.forename: Atsuyuki
authors.initials: A
authors.lastname: Hosono
authors.forename: Koichi
authors.initials: K
authors.lastname: Hanzawa
authors.forename: Masayuki
authors.initials: M
authors.lastname: Fujii
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nagano
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Isosu
mesh_terms: D000758:Anesthesia / Q000379:methods*; D001921:Brain / Q000187:drug effects / Q000502:physiology*; D003625:Data Collection; D004562:Electrocardiography; D005071:Evoked Potentials; D006801:Humans; D007036:Hypothermia, Induced; D002532:Intracranial Aneurysm / Q000601:surgery*; D007564:Japan