Endoarterectomia carotidea: valutazione di una tecnica di anestesia generale “combinata”

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COD: 185-190 Categorie: ,

Letizia Leogrande, Marco Aversano, Guglielmo Tellan, Antonio Menichetti, Giorgio Di Rocco, Andrea Redle, Francesca Frezzotti, Adriano Redler, Alain Muhindo, Giovanna Delogu

Ann. Ital. Chir., 2011 82: 185-190

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INTRODUCTION: The literature suggests several techniques to ensure the optimal anesthetic procedure for carotid surgery.
The aim of our study is to combine, in the carotid endarterectomy, a model of general anesthesia with the loco-regional
anesthesia in order to test the safety of the method, the eventual brain damage and hemodynamic stability. We also
wanted to test whether the immediate postoperative analgesia was adequate.
MATERIAL AND METHODS: Seventy eight (78) patients were enrolled in the study (from 60 to 75 years), ASA II-III, candidates
for unilateral carotid endarterectomy in a period from June 2008 to January 2009. During the procedure data
about perioperative neurologic and hemodynamic complications were collected. At the end of the surgical treatment the
pain at the awakening moment through verbal numerical scale VNS was estimated. Data are presented as mean
values ± sd and validated using the χ2 test, when required. Significance was accepted at a value of P<0.05. RESULTS: 85% of patients reported a VNS between 1 and 2 and 10% equal to 3-5. In the study 95% of patients (P.<0.05) appreciated the technique and only 3 patients reported their dissatisfaction. There was no mortality and in 5 patients a postoperative morbidity was registered. DISCUSSION: The study demonstrated the advantages in combining loco-regional anesthesia (valid monitoring of neurological and hemodynamic stability) with general anesthesia (complete airways control and patient comfort) during carotid surgery.

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