Analgosedation for Endovascular Embolization of Intracranial Arteriovenous Malformations
SCHREIBEROVÁ J., BAŠTA V., KRAJINA A.*
Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice Hradec Králové, přednosta MUDr. Vladimír Černý, PhD., FCCM |
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Summary:
The introductory part of the paper reviews the characteristics of intracranial arteriovenous malformations (AVM), current treatment options and
specific features of anesthesia and analgosedation for their treatment with endovascular embolization The sedation must be very flexible, since its
depth has to be changed rapidly to allow for contact and cooperation with a patient to perform function tests before embolization procedure is
accomplished, discarding AVM from circulation. The other part of the paper reviews the authors’ own experience with analgosedation in 75 cases of
endovascular embolization. Analgosedation is preferentially achieved by combination of fentanyl and midazolam, with bolus doses of propofol. This
strategy allows for adequate analgesia, rapidly changing depth of sedation while maintaining cardiovascular stability and adequate spontaneous
ventilation.
Key words:
arterivenous malformations – analgosedation – methohexital test
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