One of the risks of brain aneurysm surgery is loss of oxygen which can cause permanent neurological damage.

A safer technique for treating cerebral aneurysms shows great promise as a standard type of surgery.

Must general anesthesia be used for brain aneurysm surgery?
Certainly many people with aneurysms—dangerously dilated blood vessels—have wondered this.

The problem with general anesthesia (other than its usual risks) is that it prevents the patient from providing the surgeon conscious feedback during the surgery.

This feedback is crucial because the surgery can result in ischemia—interrupted oxygen to the brain.

Safer Brain Aneurysm Surgery
The August 2017 Journal of Neurosurgery reports on a first-time study using conscious sedation rather than general anesthesia for the surgical treatment of cerebral aneurysms.

Conscious sedation is also known as “awake surgery.”

The study was led by Saleem Abdulrauf, MD and chair of neurosurgery at Saint Louis University.

“This initial study is encouraging,” says Dr. Abdulrauf in the JN report.

In the clipping technique for treating cerebral aneurysms, the patient is normally put under general anesthesia.

Other brain surgeries have utilized conscious sedation to allow the patient to give the surgeon feedback. This way the surgeon knows how the patient’s brain is doing during the operation.

The Study
• Thirty patients with a non-ruptured brain aneurysm were given conscious sedation.

• During the clipping procedure they were given neurological testing.

• During the surgery, three patients – as evidenced by their conscious feedback – developed neurological problems.

• The surgeon was able to make modifications, based on that feedback, to those three patients and prevent permanent neurological complications from ischemia.

The paper notes that more studies are needed, but the study authors are enthusiastic that the conscious sedation procedure for brain aneurysm treatment will be a game changer due to its increased safety as far as ischemia.

Top image: Shutterstock/Romanova Natali