[Anesthetic practices and use of brain protective therapies for cerebral aneurysm surgery in Japan].
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.
Kan
Keiichi
K
Division of Anesthesia and Critical Care Medicine, Southern Tohoku Research Institute for Neuroscience, Koriyama 963-8563.
Hattori
Hisashi
H
Hosono
Atsuyuki
A
Hanzawa
Koichi
K
Fujii
Masayuki
M
Nagano
Tatsuya
T
Isosu
Tsuyoshi
T
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