Intracranial aneurysms (IA) occur in 3–5% of the general population and may require surgical or endovascular obliteration if the patient is symptomatic or has an increased risk of rupture. These procedures carry an inherent risk of neurological complications, and the outcome can be influenced by the physiological and pharmacological effects of the administered anesthetics. Despite the critical role of anesthetic agents, however, there are no current studies to systematically assess the intraoperative anesthetic risks, benefits, and outcome effects in this population. In this systematic review of the literature, we carefully examine the existing evidence on the risks and benefits of common anesthetic agents during IA obliteration, their physiological and clinical characteristics, and effects on neurological outcome. The initial search strategy captured a total of 287 published studies. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 28 studies were included in the final report. Our data showed that both volatile and intravenous anesthetics are commonly employed, without evidence that either is superior. Although no specific anesthetic regimens are promoted, their unique neurological, cardiovascular, and physiological properties may be critical to the outcome in vulnerable patients. In particular, patients at risk for perioperative ischemia may benefit from timely administration of anesthetic agents with neuroprotective properties and optimization of their physiological parameters. Further studies are warranted to examine if these anesthetic regimens can reduce the risk of neurological injury and improve the overall outcome in these patients.

颅内动脉瘤 (IA) 发生在普通人群中的 3-5%，如果患者有症状或破裂风险增加，可能需要手术或血管内闭塞术。这些手术存在神经并发症的固有风险，并且结果可能受到所用麻醉剂的生理和药理作用的影响。然而，尽管麻醉剂发挥着关键作用，但目前尚无研究系统评估该人群的术中麻醉风险、益处和结果影响。在这篇对文献的系统综述中，我们仔细研究了关于 IA 消除期间常用麻醉剂的风险和益处、其生理和临床特征以及对神经系统结果的影响的现有证据。最初的搜索策略总共捕获了 287 项已发表的研究。根据系统评价和荟萃分析的首选报告项目 (PRISMA) 指南，最终报告中纳入了 28 项研究。我们的数据显示，挥发性麻醉剂和静脉麻醉剂都被广泛使用，但没有证据表明其中任何一种更优越。尽管没有推广特定的麻醉方案，但其独特的神经、心血管和生理特性可能对脆弱患者的结果至关重要。特别是，有围手术期缺血风险的患者可能受益于及时施用具有神经保护特性的麻醉剂和优化其生理参数。需要进一步的研究来检验这些麻醉方案是否可以降低神经损伤的风险并改善这些患者的总体结果。