[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%).