Carotid surgery
Carotid endarterectomy and angioplasty
DOI:
https://doi.org/10.30445/rear.v16i4.1194Keywords:
Carotid, endovascular, non-invasive cerebral oximetry, neurological monitoring, stroke, superficial cervical plexus, carotid sinus, cerebral protectionAbstract
80% of strokes have an ischemic etiology, 20-25% are due to carotid artery stenosis. Carotid surgery can be open or endovascular. Anesthesia can be general or regional with the patient awake. Anesthesia with the patient awake or under superficial sedation is the gold standard for neurological monitoring. At the Hospital Universitario de Getafe, general anesthesia with ultrasound-guided blockade of the superficial cervical plexus was performed as an analgesic technique. The objective of the anesthesiologist during the intraoperative period is to guarantee myocardial and cerebral protection by controlling the factors that may contribute to the risk of ischemia. One of the critical points of surgery, due to the great hemodynamic lability it produces, is the manipulation of the carotid sinus area. Neurological monitoring (non-invasive cerebral oximetry) and cerebral protection measures are essential.
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