Title: Need of Conscious Sedation or General Anesthesia during Neuro- Interventional Procedures
Author: Rajeev Kumar Das
DOI: https://dx.doi.org/10.18535/jmscr/v6i1.84
Abstract
Background: There is always a debate regarding the type of anesthesia required in patients undergoing neuroendovascular procedures. The present study determined the prognosis of patients converted from conscious sedation to general anesthesia during neuro- interventional procedures.
Materials & Methods: It included 520 patients undergoing neuro -endovascular procedures. History of hypertension, dyslipidemia, diabetes mellitus, cigarette smoking, atrial fibrillation, and coronary artery disease was obtained. Outcome of general anesthesia and conscious sedation was obtained.
Results: Out of 520 patients, males were 340 and females were 180. The difference was significant (P-0.01). Out of 520 procedures on patients, 300 were started under conscious sedation and 220 under general anesthesia. 10 were shifted from conscious sedation to general anesthesia (GA). Most common procedure performed under GA was endovascular treatment of cerebral vasospasm (55) followed by embolization of ruptured aneurysm (50), endovascular treatment of acute ischemic stroke (48), embolization of AVM/epistaxis (45). Most common procedure performed under conscious sedation was embolization of ruptured aneurysm followed by embolization of AVM/epistaxis and endovascular treatment of cerebral vasospasm. The difference was significant (P-0.02). Most commonly seen pathology was hypertension, hyperlipidemia, diabetes mellitus, stroke, congestive heart failure, coronary artery disease and atrial fibrillation. The difference was significant (P-0.05). Reasons for conscious sedation failure was vomiting in 6 cases, movement in 3 cases and re ruptured aneurysm in 1 case. The difference was significant (P-0.01).
Conclusion: The choice of anesthesia is based on type of procedure to be performed. The failure rate of conscious sedation is relatively low. Neuro endovascular procedures can be performed under conscious sedation with care.
Keywords: Conscious sedation, General anesthesia, Neuro endovascular.
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