Anesthetic Management of Intraoperative Aneurysm Rupture: A Narrative Review

Abstract

Intraoperative aneurysm rupture (IOAR) is a serious and potentially life-threatening complication that can occur during intracranial aneurysm surgery. Understanding the perioperative risk factor contributing to IOAR may help prevention and better handle if it occurs. The anesthesiologist should be familiar with the management of IOAR to facilitate bleeding control and improve perioperative outcome. There is controversy surrounding the management of IOAR. The main goal of management includes promptly securing for control of bleeding as well as maintaining adequate cerebral perfusion and providing neuroprotection. The purpose of the present article was to review the anesthetic management during IOAR. The authors focused on the hemodynamic and intracranial pressure control for optimizing cerebral perfusion, neuroprotection during temporary arterial occlusion, monitoring of cerebral ischemia, and recent techniques for controlling bleeding. Keywords: Intraoperative aneurysm rupture; Anesthetic management; Intracranial aneurysm; Surgical clipping