Hypervolemic hypotension を用いた脳動脈瘤手術例の予後と遠隔成績 : 脳動脈瘤 104 例の自然歴について

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Among 104 cases of intracranial aneurysms, 64 were operated under hypervolemic hypotension (HVH) and Trimethaphan induced hypotensive anesthesia.Of the remaining 40 cases, 14 were operated under normotensive anesthesia, 12 were treated by common carotid clamp, and 14 were found not compatible to surgical treatment because od recurrent bleeding, vasospasm and other serious complications.The advantages and surgical results of HVH, including morbidity, mortality, and complications are discussed and compared with several other reports of induced hypotensive anesthesia.The benefits of the HVH are as follows:1)Cerebral metabolism is maintained within normal range during the prolonged induced hypotension by hypervolemic perfusion.2)The dissection and clipping of aneurysm are considerably easier and premature rupture occurring during surgical manipulation of the aneurysm can be handled without difficulty.3)The hypervolemic hypotension may diminish the danger of postoperative cerebral swelling and edema, and improve the prognosis and long-term survival of the intracranial aneurysm patients.
日本脳神経外科学会の論文
1979-09-15