[Anaesthesia. Resuscitation problems arising from the surgical treatment of chemodectomas in the carotid fork...

Chemodectomas in the carotid fork are rare and usually benign tumours. Their removal by surgery creates certain problems in terms of operating technique since they are, anatomically, awkwardly situated. An additional problem arises from loss of blood resulting from their removal and possible cardiac disturbance which might affect the functioning of the carotid sinus should the tumours have been situated in this region. Furthermore, the possible eventuality of having to clamp the internal carotid for a short or even long time, should the operation require it, presupposes a perfect knowledge of the patient's cerebral circulation. Hence, therefore, the necessity of a verification of this circulation by centrolateral carotid arteriography to confirm the permeability of the circle of Willis and a potentially good supply of blood when the blood in the region of the tumour is restricted. It is equally necessary to have a complete record of the general state of the patient's cardiovascular, circulatory, respiratory, renal and neurological conditions. These must, within certain limits, be deemed satisfactory before the decision to operate is taken. Indeed, it is these conditions that will determine the per-operative as well as the post-operative condition of the patient.