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Signa vitae : journal for intesive care and emergency medicine, Vol. 7 No. 2, 2012.

Original scientific paper

Anesthesia techniques for carotid endarterectomy

DINKO TONKOVIĆ ; University of Zagreb, Department of Anesthesiology, Reanimatology and Intensive Care, University Hospital “Sv. Duh”, Sv. Duh 64, 10 000 Zagreb, Croatia
DANIJELA BANDIĆ-PAVLOVIĆ ; University of Zagreb, Department of Anesthesiology, Reanimatology and Intensive Care, University Hospital Center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
ROBERT BARONICA ; University of Zagreb, Department of Anesthesiology, Reanimatology and Intensive Care, University Hospital Center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
TAJANA ZAH-BOGOVIĆ ; University of Zagreb, Department of Anesthesiology, Reanimatology and Intensive Care, University Hospital Center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
SANJA SAKAN ; University of Zagreb, Department of Anesthesiology, Reanimatology and Intensive Care, University Hospital Center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
ELONORA GOLUŽA ; University of Zagreb, Department of Anesthesiology, Reanimatology and Intensive Care, University Hospital Center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
ŽELJKO DRVAR ; University of Zagreb, Department of Anesthesiology, Reanimatology and Intensive Care, University Hospital Center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia

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Abstract

Stroke is one of the leading causes of death in the modern countries. Mainstay treatment for stroke prevention is carotid endarterectomy (CEA). Patients scheduled for surgery often have many associate systemic illnesses that pose a risk of perioperative cardiac and neurological complications. Detailed preoperative evaluation of neurological and cardiac function with optimization of the systemic illnesses therapy is obligatory. Ideal anesthesiology technique should provide adequate analgesia, minimal stress response, optimal brain perfusion and oxygenation, optimal hemodynamic and myocardial oxygen balance while assuring calm and relaxed patients with good surgical comfort. Both regional anesthesia and general anesthesia have some advantages and drawbacks. Regarding to cerebral and myocardial ischemia and adverse outcome after CEA, especially in high risk patients, today still it is not clear which anesthesia technique is preferred for CEA. Greatest risk in the early postoperative period is new neurological deficit caused by cerebral ischemia end myocardial infarction caused with hemodynamic instability and therefore CEA patients are placed in the Intensive Care Unit for at least six or more hours where they are monitored for neurological and hemodynamic complications.

Keywords

anesthesia; carotid endarterectomy

Hrčak ID:

102547

URI

https://hrcak.srce.hr/102547

Publication date:

1.10.2012.

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