Department of Anesthesiology, Medical College of Wisconsin, 8701 West Watertown Plank Road, Milwaukee, WI 53132, USA.
Department of Neurosurgery, Medical College of Wisconsin, 8701 West Watertown Plank Road, Milwaukee, WI 53132, USA.
Anesthesiol Clin. 2021 Mar;39(1):1-18. doi: 10.1016/j.anclin.2020.10.001. Epub 2021 Jan 9.
Anesthesia for intracranial vascular procedures is complex because it requires a balance of several competing interests and potentially can result in significant morbidity and mortality. Frequently, periods of ischemia, where perfusion must be maintained, are combined with situations that are high risk for hemorrhage. This review discusses the basic surgical approach to several common pathologies (intracranial aneurysms, arteriovenous malformations, and moyamoya disease) along with the goals for anesthetic management and specific high-yield recommendations.
颅内血管手术的麻醉较为复杂,因为需要平衡多种相互竞争的因素,而且可能会导致严重的发病率和死亡率。通常,需要维持灌注的缺血期与出血风险高的情况相结合。本篇综述讨论了几种常见病变(颅内动脉瘤、动静脉畸形和烟雾病)的基本手术方法,以及麻醉管理的目标和具体的高收益建议。