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[Carotid endarterectomy under cervical epidural anesthesia]
Y Asano1, M Hasuo, S Shimosawa
1Department of Neurosurgery and Anaesthesia, Kariya General Hospital, Aichi, Japan.
No Shinkei Geka. Neurological Surgery
|September 1, 1993
Summary
Cervical epidural anesthesia (EDA) allows patients to remain conscious during carotid endarterectomy (CEA), providing a reliable method for monitoring neurological function. This technique offers a safe and effective alternative to general anesthesia for CEA procedures.
Area of Science:
- Neurology
- Anesthesiology
- Vascular Surgery
Context:
- Carotid endarterectomy (CEA) traditionally uses general anesthesia, complicating intraoperative cerebral function monitoring.
- Detecting cerebrovascular insufficiency under general anesthesia remains challenging.
- Cervical epidural anesthesia (EDA) offers a potential solution by maintaining patient consciousness.
Purpose:
- To evaluate the safety and efficacy of cervical epidural anesthesia (EDA) for carotid endarterectomy (CEA).
- To assess the utility of maintaining patient consciousness as a neurological monitor during CEA.
- To determine if EDA is a viable alternative to general anesthesia for CEA.
Summary:
- Five patients with internal carotid artery stenosis underwent CEA under cervical epidural anesthesia (EDA) with lidocaine.
- EDA provided effective analgesia and allowed for continuous neurological assessment.
- Transient blood pressure fluctuations were manageable, and neurological deterioration prompted successful internal shunt insertion.
Impact:
- Cervical epidural anesthesia (EDA) is a safe and effective anesthetic technique for carotid endarterectomy (CEA).
- Maintaining patient consciousness during CEA provides a valuable method for monitoring cerebral function.
- EDA can be recommended for a significant number of patients undergoing CEA.