[Anaesthetic considerations for interventional radiology].

OBJECTIVE

To describe the new procedures applied for interventional radiology leading to specific anaesthetic care and organization.

DATA SOURCE

Record of references from national and international journals in Medline.

STUDY SELECTION

All types of articles were selected including prospective studies, practice guidelines, reviews and case reports.

DATA SYNTHESIS

During interventional radiology, anaesthesia should be adapted to the duration of the procedure, the pain induced by the radiologist, the position of the patient and its medical status. General anaesthesia would be preferred for long procedures, requiring total immobility. Locoregional anaesthesia can be proposed for some cases. Sedation associating hypnotics (propofol, midazolam, sevoflurane) and opioids (alfentanil, remifentanil) is commonly used according to different schemes, as discontinuous boluses, continuous infusion, target controlled intravenous sedation or patient controlled sedation. Monitoring of temperature and diuresis may be useful for long procedures. Haemodynamic monitoring (arterial catheter, central venous pressure) and haemostatic monitoring may be necessary for interventional neuroradiology and endovascular stenting. Radiofrequency and laser procedures are often painful, requiring the choice of adequate analgesic regimen. Hydratation associated with acetylcysteine seems to be able to prevent contrast induced nephropathy in patients with risk factors for chronic renal insufficiency.

CONCLUSION

As advances in interventional radiology are obvious, general organisation as well as anaesthetic procedures should be adapted to these specific techniques.