[Anesthesia and intensive care of subarachnoid hemorrhage. A survey on practice in 32 centres].

OBJECTIVE

To assess the current practices in anaesthesia and intensive care in patients experiencing subarachnoid haemorrhage (SAH).

STUDY

DESIGN

Analysis of questionnaire sent to the members of the French speaking Association of neuroanesthesia and intensive care.

METHODS

The survey, performed in the summer of 1995, included questions on the composition of the neuroanesthesia team, anaesthesia, as well as medical and surgical treatments.

RESULTS

Twenty-nine French and three non French centers answered the questionnaire. In 14 centers, more than 60 SAH had been treated in the previous year. Angiography was performed under sedation with a benzodiazepine associated with an opioid (54%). Criteria for choosing an endovascular approach were the site of the aneurysm (81%), its neck size (42%) and the underlying disease (42%). Anaesthesia was induced with either propofol (60%) or thiopentone (40%) associated with an opioid and a muscle relaxant. It was maintained with either isoflurane (59%) or propofol (41%). Nitrous oxide was often associated (62%). During anaesthesia, nimodipine (84%), mannitol (69%), anticonvulsants (47%), dopamine (31%) and lidocaine (9%) were also administered. Postoperatively, nimodipine was administered for prophylaxis of vasospasm (97%) and transcranial Doppler was employed to diagnose vasospasm (50%). Other techniques of care included hypervolaemia (89%), controlled arterial hypertension (36%) and haemodilution (36%).