AANA journal course: update for nurse anesthetists--carotid endarterectomy: anesthetic implications

Carotid endarterectomy reduces the risk of stroke or death in patients with high-grade symptomatic carotid artery disease. Regional anesthesia-which uses the awake patient as a monitor for cerebral ischemia-is a viable alternative to general anesthesia for patients undergoing carotid endarterectomy. There are very few complications with the deep and superficial cervical plexus blocks when administered by a careful anesthetist trained to perform this procedure. Patients receiving regional anesthesia also have fewer intraoperative carotid artery shunts and cardiac complications. The preoperative, intraoperative, and postoperative management of the carotid endarterectomy patient receiving either a regional or general anesthetic is reviewed.