In this prospective study the authors have used directed moderate hypothermia as a neuroprotective method in patients undergoing surgical treatment for an intracranial aneurysm. The set involved 38 patients with the diagnosed intracranial aneurysm (score according to Hunt and Hess I – III) operated on at the Clinic of Neurosurgery, University Hospital Brno within 2003 and 2004. After introducing into anaesthesia, the cooling was started on two circulating water mattresses (Blanketrol III, Cincinnaty Sub Zero). Active cooling was discontinued after reaching the temperature of 35 °C. The body temperature of 34 °C was maintained during the preparation of cerebral blood-vessels. After applying a staple, active warming was started. The average period of anaesthesia duration was 358 ± 49 minutes, the operation lasted for 285 ± 37 minutes. Blood loss was 430 ± 130 ml. In the introduction into anaesthesia, the temperature of the body core was 37.1 ± 0.4 °C, and during intervention the lowest temperature of the body core 33.8 ± 0.4 °C was reached. When the patient was leaving the operation room, the body core temperature was 35.8 ± 0.5 °C. Patients were cooled at a speed of 0.9 ± 0.3 °C/hr, and warmed at a speed of 0.7 ± 0.4 °C/hr. The required temperature of the body core was attained in all the patients, i.e. in 100 % cases. The measured values of body temperature in the esophagus and urinary bladder did not differ statistically significantly, p = 0.49. The statistical comparison of pre-operative coagulation parameters with the values measured in per-operative period during directed hypothermia has shown no significant differences. The level of thrombocytes before a surgery was 202 ± 36, in the course of per-operative hypothermia 207 ± 33, p = 0.96. The value of INR before surgery was 1.0 ± 0.1, during per-operative directed hypothermia 1.1 ± 0.1, p = 0.40. The APTT value before surgery was 29 ± 3, during per-operative directed hypothermia 34 ± 4, p = 0.06. Neurological condition was assessed as good in 35 patients (92 %). Two patients died, and one was in a vegetative state.

        Key words: intracranial surgery of aneurysms, moderate hypothermia, anaesthesia conduction