Anesthetic Management of Carotid Endarterectomy: A case report.
10.4097/kjae.1999.36.2.349
- Author:
Jung In BAE
1
;
Sang Jick LEE
Author Information
1. Department of Anesthesiology, Keimyung University School of Medicine, Taegu, Korea.
- Publication Type:Case Report
- Keywords:
Brain, transient ischemic attacks;
Monitoring, electroencephalography;
Surgery, carotid endarterectomy
- MeSH:
Anesthesia, General;
Arterial Pressure;
Body Weight;
Brain Ischemia;
Carotid Stenosis;
Electrocardiography;
Electroencephalography;
Endarterectomy, Carotid*;
Glycopyrrolate;
Humans;
Ischemic Attack, Transient;
Isoflurane;
Male;
Middle Aged;
Myocardial Ischemia;
Neurologic Manifestations;
Pancuronium;
Perfusion;
Premedication;
Succinylcholine;
Thiopental;
Triflupromazine;
Ventilation
- From:Korean Journal of Anesthesiology
1999;36(2):349-353
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Carotid endarterectomy is the preferred treatment for a patient with transient ischemic attacks (TIAs) in whom carotid artery stenosis is present. This patient was a 58-year-old male associated with 60 kg in body weight and 172 cm in height. He was scheduled for elective carotid endarterectomy in ASA physical status III. For premedication, he was administered triflupromazine (Veprin ) 10 mg and glycopyrrolate 0.2 mg IM 1 hour prior to induction. Induction was established with thiopental sodium, succinylcholine after preoxygenation. N2O/O2 (2:1), isoflurane and pancuronium were administered for maintenance. For monitoring, ECG, EEG, direct arterial pressure, ETCO2, CVP and rectal temperature were performed. A primary goal of the intraoperative management is the prevention of the cerebral ischemia. He was challenged to maintain adequate cerebral perfusion without causing myocardial ischemia. The EEG is the reliable indication of cortical function during general anesthesia. No signs of the cerebral ischemia were occurred at the time of the carotid occlusion. Minute ventilation was kept mild hypo-or normocapnia. He had no new neurologic deficits and myocardial ischemia, and discharged on 14 day postoperation.
