Abstract

BAYTER MARIN, Jorge Enrique; BAYTER MARIN, Alejandro; BARRERA CARVAJAL, Juan Guillermo  and  MATEUS CAICEDO, Ligia Cecilia. Endarterectomía carotidea. ¿Es la anestesia regional nuestra única alternativa?. Rev. colomb. anestesiol. [online]. 2006, vol.34, n.2, pp.95-101. ISSN 0120-3347.

Carotid endarterectomy is a prophylactic intervention performed to relieve neurological symptoms from carotid atherosclerosis, and prevent cerebral infarction and subsequent neurological deficits. "Prophylactic" implies major responsability from surgical team as it is performed in a patient on whom we are seeking to avoid a neurologic event years later. The purpose of the study is to create awareness in the anestesiologist that if intraoperative neurologic monittoring is not available, the only alternative is regional anesthesia, which allows fast diagnosis and treatment of periods of hypoperfusion or embolism. In serious investigations woldwide it is not mentioned performing carotid endarterectomy under general anesthesia without intraoperative monitoring. Based on this argument, Since March of 2002, La Fundacion Cardiovascular de Colombia all carotid endarterectomies are being performed with block of the cervical plexus and the objective of this paper is to present a report with the first 20 cases in which endarterectomy was performed under regional anesthesia, until November 2005. We were able to avoid neurologic adverse events during the intraoperative period in 2 patients (10%), reduce po neurologic complications, ICU stay and hospital stay around 50% compared to previous years, when the procedure was performed under general anesthesia.

Keywords : Carotid endarterectomy; Regional anesthesia; Prophylactic intervention.

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