Anesthetic Management for Clipping a Intracranial Giant Aneurysm with Low-flow Deep Hypothermic Cardiopulmonary Bypass and Propofol Infusion: A case report.

Jeon,  Sang Yoon; Lee,  Jeong Rak; Kim,  Jung Won; Choe,  Won Ju; Kim,  Kyung Tae; Lee,  Sang Il

doi:2005.49.3.443

Case Report

Korean Journal of Anesthesiology 2005;49(3):443-446.
DOI: https://doi.org/10.4097/kjae.2005.49.3.443

Anesthetic Management for Clipping a Intracranial Giant Aneurysm with Low-flow Deep Hypothermic Cardiopulmonary Bypass and Propofol Infusion: A case report.

Sang Yoon Jeon, Jeong Rak Lee, Jung Won Kim, Won Ju Choe, Kyung Tae Kim, Sang Il Lee

Department of Anesthesiology and Pain Medicine, College of Medicine, Inje University, Ilsan, Korea. jr1001@lycos.co.kr

Abstract

A 35-year-old male patient underwent surgery to clip a giant middle cerebral artery aneurysm with closed-chest cardiopulmonary bypass using femorofemoral bypass. Deep hypothermia (18-20 degrees C), low-flow cardiopulmonary bypass and propofol infusion (6-8 mg/kg/h) were used under general anesthesia. Venous drainage via femoral vein was suffcient and ventricular distension was not observed on transesophageal echocardiography. On Electroencephalogram, burst suppression pattern was presented due to deep hypothermia and propofol infusion. Instead of deep hypothermic circulatory arrest perfusion flow was maintained at low-flow (33 ml/kg/min) during aneurysmal clipping. Postoperatively, the patient was transferred to intensive care unit and discharged without neurological deficit.

Key Words: cardiopulmonary bypass; cerebral protection; deep hypothermia; propofol