Anesthesia for Embolization from 2003-2004 in Siriraj Hospital: A Retrospective Study

Abstract

Objective: To report and evaluate the choices and techniques of anesthesia, drug usage and complications at Siriraj Hospital.

Methods: Retrospectively analyzed the patients on whom embolization had been performed during the period of January, 2003 to October, 2004 in Siriraj Hospital. The patientsû characteristics, preanesthetic problems, anesthetic techniques, anesthetic agents, embolization agents and complications were assessed.

Results: There were 292 cases and 476 procedures. The age group of 20-29 years was the highest one (27.9%). Most patients had American Society of Anesthesiologist (ASA) class I (60.3%). The diagnoses were brain arteriovenous malformation (30.3%), carotid cavernous sinus fistula (23.5%), other arteriovenous malformations (11.8%), hemangioma (7.8%), venous malformation (3.6%), arteriovenous fistula (2.3%), angiofibroma (2.3%), hemoptysis (2.1%), brain aneurysm (1.7%), gastrointestinal bleeding (1.3%) and others (13.3%). Hematologic disease, hypertension and neurological disease were the most common preanesthetic problems. General anesthesia with endotracheal tube was the anesthetic technique mainly employed (71.0%). Anesthetic agents were mainly administered with propofol, fentanyl and succinylcholine. The mean anesthetic time was 132.5 ± 63.0 minutes. The embolization agents were glue (42.0%), balloon (20.6%), alcohol (13.2%), ivolon (7.1%), coil (6.9%) and gel foam (0.4%). The most frequent anesthetic complication was hypotension.

Conclusion: During anesthetic management for embolization, special techniques or drugs in anesthesia are not routinely required, although the anesthetic personnel had to optimize the patientûs condition for safety and there should be an awareness of complications.