PERIOPERATIVE MANAGEMENT OF ANEURYSMAL SU BARACHNOID HEMORRHAGE - CURRENT PRACTICES IN 32 CENTERS

Objective: To assess the current practices in anaesthesia and intensiv e care in patients experiencing subarachnoid haemorrhage(SAH). Study d esign: Analysis of questionnaire sent to the members of the French spe aking Association of neuroanesthesia and intensive care. Methods: The survey, performed in the summer of 1995, included questions on the com position of the neuroanesthesia team, anaesthesia, as well as medical and surgical treatments. Results: Twenty-nine French and three non Fre nch centers answered the questionnaire. In 14 centers, more than 60 SA H had been treated in the previous year. Angiography was performed und er sedation with a benzodiazepine associated with an opioid (54%). Cri teria for choosing an endovascular approach were the site of the aneur ysm (81%), its neck size (42%) and the underlying disease (42%). Anaes thesia was induced with either propofol (60%) or thiopentone (40%) ass ociated with an opioid and a muscle relaxant. It was maintained with e ither isoflurane (59%) or propofol (41%). Nitrous oxide was often asso ciated (62%). During anaesthesia, nimodipine (84%), mannitol (69%), an ticonvulsants (47%), dopamine (31%) and lidocaine (9%) were also admin istered. Postoperatively, nimodipine was administered for prophylaxis of vasospasm (97%) and transcranial Doppler was employed to diagnose v asospasm (50%). Other techniques of care included hypervolaemia (89%), controlled arterial hypertension (36%) and haemodilution (36%).