Guidelines for the anesthetic management of aSAH: Difference between revisions

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===Anesthetic Management During Surgical and Endovascular Treatment: Recommendations===
{|class="wikitable"
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
|colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (Harm)
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' Induced [[hypothermia]] during aneurysm surgery is not routinely recommended but may be a reasonable option in selected cases ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
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{|class="wikitable"
{|class="wikitable"
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|colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (Harm)
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Minimization of the degree and duration of intraoperative [[hypotension]] during aneurysm surgery is probably indicated  ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
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|bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' There are insufficient data on pharmacological strategies and induced hypertension during temporary vessel occlusion to make specific recommendations, but there are instances when their use may be considered reasonable ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
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{|class="wikitable"
{|class="wikitable"
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| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Prevention of intraoperative [[hyperglycemia]] during aneurysm surgery is probably indicated ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.'''  ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' The use of general anesthesia during endovascular treatment of ruptured cerebral aneurysms can be beneficial in selected patients ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|}
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Latest revision as of 00:13, 22 November 2016

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AHA/ASA Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage (2012)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Sara Mehrsefat, M.D. [2]

2012 AHA/ASA Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage[1]

Anesthetic Management During Surgical and Endovascular Treatment: Recommendations

Class III (Harm)
"1. Induced hypothermia during aneurysm surgery is not routinely recommended but may be a reasonable option in selected cases (Level of Evidence: B)"
Class IIa
"1. Minimization of the degree and duration of intraoperative hypotension during aneurysm surgery is probably indicated (Level of Evidence: B)"
"2. There are insufficient data on pharmacological strategies and induced hypertension during temporary vessel occlusion to make specific recommendations, but there are instances when their use may be considered reasonable (Level of Evidence: C)"
Class IIb
"1. Prevention of intraoperative hyperglycemia during aneurysm surgery is probably indicated (Level of Evidence: B)"
"2. The use of general anesthesia during endovascular treatment of ruptured cerebral aneurysms can be beneficial in selected patients (Level of Evidence: C)"


References

  1. Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage http://stroke.ahajournals.org/content/early/2012/05/03/STR.0b013e3182587839

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