Carotid endarterectomy: a study of cerebral oxygen saturation vs stump pressure
1Dept of Anaesthesia, College of Med, King Saud University, Riyadh 11461, Saudi Arabia. dawlatly@ksu.edu.sa
Background And Aims:
Carotid endarterectomy (CEA) is an established surgical procedure for treatment of internal carotid artery (ICA) stenosis. To determine whether or not a carotid shunt is necessary to place, some surgeons measure the stump pressure. We conducted the current study in order to identify whether or not cerebral oxygen saturation (rS02%) can serve as another quantitative measurement to determine the need of carotid shunt during CEA.
Materials And Methods:
Ten patients who underwent CEA under general anesthesia were studied. The stump pressure was measured during ICA clamping and rSO2% was measured during three phases: A) prior to ICA clamping, B) during ICA clamping and C) after ICA declamping. The data were subjected to one-way ANOVA and correlation coefficient analysis. The mean age was 62+/-7 yr and the mean body weight was 66+/-7kg.
Results:
The stump pressure and rSO2% mean values were 45+/-9 mmHg and 57+/-7% respectively during ICA clamping. Correlation coefficient revealed significant positive relationship, r = 0.724(P = 0.009).
Conclusions:
rSO2% may serve as another quantitative measurement to determine the need for carotid shunt during CEA surgery. Due to the small number of cases in the current study, the critical rSO2% which warrants carotid shunt placement could not be identified. Therefore, large number of patients are required to define the critical rSO2% during CEA surgery.
