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Anesthesia for carotid endarterectomy: a survey
M A Cheng1, M A Theard, R Tempelhoff
1Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri, USA.
Journal of Neurosurgical Anesthesiology
|July 1, 1997
Summary
Most anesthesiologists prefer general anesthesia (GA) for carotid endarterectomy (CEA), despite ongoing debates favoring regional anesthesia (RA). This survey reveals current anesthetic practices for CEA, including neuromonitoring and neuroprotection.
Area of Science:
- Neurosurgery
- Anesthesiology
- Vascular Surgery
Background:
- Indications for carotid endarterectomy (CEA) have expanded, yet the optimal anesthetic approach remains debated.
- This study addresses the ongoing discussion regarding the ideal anesthetic for CEA.
Purpose of the Study:
- To evaluate current anesthetic techniques employed by anesthesiologists for carotid endarterectomy.
- To understand the prevalence of general anesthesia versus regional anesthesia in CEA procedures.
Main Methods:
- A survey was distributed to members of the Society of Neurosurgical Anesthesia and Critical Care (SNACC).
- A total of 426 questionnaires were mailed, with 216 (50.7%) returned and analyzed.
Main Results:
- General anesthesia (GA) was administered by 84.7% of respondents for CEA.
- Regional anesthesia (RA) was chosen by 16.7%, with local anesthesia (LOC) or combined techniques used by fewer.
- Nitrous oxide was used by 74.6%, intraoperative neuromonitoring by 90% (EEG favored), and neuroprotection by 22.2%.
Conclusions:
- Despite arguments favoring RA, the majority of surveyed anesthesiologists prefer GA for carotid endarterectomy.
- Current practices include widespread use of nitrous oxide and neuromonitoring, with less frequent application of specific neuroprotective measures.