Health Condition 1: G00-G99- Diseases of the nervous system Health Condition 2: D80-D89- Certain disorders involving the immune mechanism Health Condition 3: G973- Intraoperative hemorrhage and hematoma of a nervous system organ or structure complicating a procedure Health Condition 4: G973- Intraoperative hemorrhage and hematoma of a nervous system organ or structure complicating a procedure Health Condition 5: G978- Other intraoperative and postprocedural complications and disorders of nervous
Conditions
Interventions
Intervention1: Sevoflurane: Sevoflurane will be used in dose of 1- 1.3 MAC for induction and upto procedure completed. Effect on diameter of measure cerebral vessel will be noted by digital subtractio
Sponsors
Director PGIMER
Eligibility
Inclusion criteria
Inclusion criteria: Adults patients (age 18 yrs) with cerebral vasospasm following aneurysmal subarachnoid hemorrhage posted for intra-arterial nimodipine who are either unconscious,semiconscious,irritable or intubated and need for general anaesthesia for the procedure
Exclusion criteria
Exclusion criteria: 1. Patient or legal heir’s refusal for consent 2. Patient with H/O allergy to test drugs 3. Patient who received intraarterial Nimodipine previously. 4. Patients having deranged renal parameters 5. Patients with vasculitis. 6. Patient having hydrocephalus. 7. Patients having abnormal coagulation parameters
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Effect on diameter of major cerebral vessels ICA,MCA,ACATimepoint: Baseline before giving general anesthesia and after nimodipine administration | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. To assess changes in Cerebral Arterio-Venous Transit Time which is a surrogate marker of the cerebral blood flow by DSA. 2. Cerebral blood flow velocity (SFV/DFV/MFV), Pulsatility Index (PI) and Lindegaard ratio measured by TCD, before the procedure, 1 hour and 24 hours after procedure. These parameters will be measured once daily again for 1-5 days after IA Nimodipine. 3. Total dose of intra-procedure nimodipine. 4. Requirement of additional doses of Intra-arterial nimodipine during ICU stay. 5. Development of cerebral infarction during ICU stay. 6. Neurological status of the patients at discharge by Modified Rankin score (mRS). Timepoint: 0 Days till discharge | — |
Countries
India
Contacts
Public ContactSk Ahadul Islam
Post Graduate Institute of medical education and research
Outcome results
None listed