2014
DOI: 10.4103/0970-9185.137261
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Principles of neuroanesthesia in aneurysmal subarachnoid hemorrhage

Abstract: Aneurysmal subarachnoid hemorrhage is associated with high mortality. Understanding of the underlying pathophysiology is important as early intervention can improve outcome. Increasing age, altered sensorium and poor Hunt and Hess grade are independent predictors of adverse outcome. Early operative interventions imposes an onus on anesthesiologists to provide brain relaxation. Coiling and clipping are the two treatment options with increasing trends toward coiling. Intraoperatively, tight control of blood pres… Show more

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Cited by 49 publications
(43 citation statements)
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“…Rapid recovery from neuroanesthesia and early neurologic examination are also important. Hemodynamic stability, especially with regard to arterial pressure to aid adequate cerebral perfusion, is a cornerstone of neuroanesthesia management (Flexman, Meng, & Gelb, ; Kundra, Mahendru, & Gupta, ). Studies have reported that 40%–80% of neurosurgical patients experience moderate‐to‐severe postoperative pain.…”
Section: Introductionmentioning
confidence: 99%
“…Rapid recovery from neuroanesthesia and early neurologic examination are also important. Hemodynamic stability, especially with regard to arterial pressure to aid adequate cerebral perfusion, is a cornerstone of neuroanesthesia management (Flexman, Meng, & Gelb, ; Kundra, Mahendru, & Gupta, ). Studies have reported that 40%–80% of neurosurgical patients experience moderate‐to‐severe postoperative pain.…”
Section: Introductionmentioning
confidence: 99%
“…A cute subarachnoid hemorrhage (SAH) is a serious condition that affects not just the brain, but multiple other organ systems as well (1). Despite a steady reduction of mortality from acute SAH in recent years, from over 50% to approximately 35%, this entity is still associated with considerable morbidity and mortality (1, e1-e13).…”
mentioning
confidence: 99%
“…Ten to 25 percent of all patients with acute SAH die immediately after the bleed or before arrival at the hospital (e6). Approximately onethird ultimately remain permanently dependent on nursing care, and only 30% are able to return to independent living (1). The clinical outcome depends on multiple factors, including the severity of the acute bleed, the patient's initial condition, the presence or absence of early re bleeding, and the presence or absence of delayed cerebral ischemia (DCI).…”
mentioning
confidence: 99%
“…1 A rare and serious complication is postoperative submandibular sialadenitis along with diffuse soft tissue swelling of the neck occurring following extreme degrees of head positioning. 2 This can cause severe respiratory distress postoperatively.…”
mentioning
confidence: 99%
“…Fentanyl and local infiltration were given for analgesia. Invasive BP, HR, CVP, PPV, temperature, and end-tidalCO 2 were monitored. Burst suppression with thiopentone was used during temporary occlusion.…”
mentioning
confidence: 99%