+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Carotid endarterectomy under cervical epidural anesthesia

Carotid endarterectomy under cervical epidural anesthesia

No Shinkei Geka. Neurological Surgery 21(9): 787-791

General anesthesia for carotid endarterectomy (CEA) imposes the need for various monitorings of cerebral function during occlusion of the carotid artery. However, there is no ideal method for detecting all the signs of cerebrovascular insufficiency under general anesthesia. We suggest that the patient's neurological state is the best monitor of cerebral function. Therefore, our patients underwent cervical epidural anesthesia (EDA) enabling them to remain conscious while experiencing analgesia of the operated areas throughout the course of the operation. Five patients with cervical internal carotid artery stenosis were operated on under EDA with lidocaine. In all patients, EDA was effective in maintaining an analgesic state in the areas being operated on. It was able to do this either alone, or in combination with a light sedation. Under EDA, although there was no complete suppression of the patient's respiration, blood pressure was elevated beyond 200mmHg in three patients and depressed to 70mmHg in one patient transiently during the operation. But control of abnormal blood pressure was achieved easily by injections of calcium antagonist or ephedrine. When consciousness of two patients deteriorated during the clamping of the internal carotid artery, it completely recovered to its preoperative level after the insertion of an internal shunt. The patient's level of neurological condition became a good guide for predicting the need for an internal shunt during the periods of occlusion of the internal carotid artery. In conclusion, we suggest that EDA which is a safe and useful anesthesia should be employed in many patients who undergo CEA.

Please choose payment method:

(PDF emailed within 1 workday: $29.90)

Accession: 008268032

Download citation: RISBibTeXText

PMID: 8377894

Related references

Cervical epidural anesthesia in carotid endarterectomy. Rozhledy V Chirurgii 77(9): 405-407, 1998

Cervical Epidural Anesthesia for Carotid Endarterectomy. Surgery Gynecology and Obstetrics 117: 366-367, 1963

Carotid endarterectomy under cervical epidural anesthesia. Analysis of neurologic manifestations. Annales Francaises d'Anesthesie et de Reanimation 7(1): 36-41, 1988

Combined carotid endarterectomy and off-pump coronary artery bypass surgery under thoracic epidural anesthesia without endotracheal general anesthesia. Journal of Cardiothoracic and Vascular Anesthesia 20(6): 850-852, 2006

Carotid endarterectomy in cervical block anesthesia in patients with occluded contralateral internal carotid artery. Srpski Arhiv Za Celokupno Lekarstvo 134(3-4): 122-128, 2006

Converting from general anesthesia to cervical block anesthesia for carotid endarterectomy. Vascular Surgery 35(2): 103-106, 2001

Cervical epidural anesthesia an alternative to cervical block for carotid artery surgery. Anesthesiology 71(3A): A725, 1989

High thoracic epidural anesthesia in patients with synchronous carotid endarterectomy and off-pump coronary artery revascularization. Vojnosanitetski Pregled 70(12): 1132-1137, 2013

Cervical plexus anesthesia for carotid endarterectomy: comparison of ropivacaine and mepivacaine. Canadian Journal of Anaesthesia 47(2): 185-187, 2000

Hemodynamic Changes in Patients Undergoing Carotid Endarterectomy Under Cervical Block and General Anesthesia. Journal of Vascular Surgery 58(5): 1430-1431, 2013

Hemodynamic changes in patients undergoing carotid endarterectomy under cervical block and general anesthesia. Annals of Vascular Surgery 28(7): 1680-1685, 2014

Postoperative blood pressure changes associated with cervical block versus general anesthesia following carotid endarterectomy. Annals of Vascular Surgery 13(1): 104-108, 1999

Cervical epidural anesthesia for carotid mycotic aneurysms. Revista Espanola de Anestesiologia Y Reanimacion 42(8): 341-343, 1995

Cervical epidural anesthesia in carotid artery surgery. Presse Medicale 18(18): 927-931, 1989

Continuous cervical epidural anesthesia for carotid endarterectomies. Acta Anaesthesiologica Italica 43(1): 37-41, 1992