scholarly journals Markers of ischemic neuronal damage, neurological complications of carotid endarterectomy and their management depending on anesthesia type

2013 ◽  
Vol 94 (1) ◽  
pp. 13-17
Author(s):  
V V Shmelev ◽  
M I Neymark
Keyword(s):  
Carotid Endarterectomy ◽  
Neurological Disorders ◽  
Neuronal Damage ◽  
Brain Perfusion ◽  
Neurological Status ◽  
Neurological Complications ◽  
Inhalational Anesthesia ◽  
Intravenous Anesthesia ◽  
Cervical Plexus Block ◽  
Plexus Block

Aim. to identify the anesthesia method for carotid endarterectomy providing minimal ischemic neuronal damage and decreasing the number of post-surgical complications; to adjust the optimal treatment for associated neurological disorders. Methods. An assessment of anesthesia methods was performed in 190 patients who underwent the carotid endarterectomy. The intravenous anesthesia with propofol (first group, 60 patients), regional anesthesia using deep cervical plexus block (second group, 60 patients), and inhalational anesthesia with sevoflurane (third group, 70 patients) were compared. Brain perfusion parameters, neurological status, ischemic neuronal damage markers were examined. Results. In patients undergoing carotid endarterectomy an ischemic neuronal damage is provoked due to brain perfusion decrease as a result of common carotid artery clipping regardless of anesthesia method. Inhalational anesthesia was associated with relatively lower ischemic neuronal damage markers levels. Some patients form every group have developed serious post-surgical neurological complications (stroke, transient cerebral ischemic attack, neurological status deterioration). Post-surgical complications were registered in 10 (16.7%) patients from the first group, in 9 (15%) patients form the second group, in 3 (4.3%) patients from the third group. Citicoline was the most effective drug for associated neurological disorders treatment. Conclusion. Inhalational anesthesia with sevoflurane compared to intravenous anesthesia with propofol and regional anesthesia using deep cervical plexus block limits the neuronal damage and is associated with lower number of post-surgical neurological complications, which can be treated with citicoline.

scholarly journals Significance of lipid peroxidation disorders in genesis of neurological disorders after carotid endarterectomy

2019 ◽  
Vol 1 (16) ◽  
pp. 13-16
Author(s):  
B. A. Shadymov ◽  
M. I. Neimark ◽  
V. V. Shmelyov ◽  
A. A. Shaidurov
Keyword(s):  
Lipid Peroxidation ◽  
Surgical Treatment ◽  
Carotid Artery ◽  
Succinic Acid ◽  
Carotid Endarterectomy ◽  
Postoperative Period ◽  
Neurological Disorders ◽  
Neuronal Damage ◽  
Neurological Complications ◽  
Comparative Characteristic

The article considers the question of the appropriateness of the use of the drug based on succinic acid in the surgical treatment of atherosclerotic occlusion of the carotid artery, for the prevention of neurological complications in the postoperative period. A comparative characteristic of the obtained data of oxidative, antioxidant statuses, as well as markers of neuronal damage in two groups was carried out. The results suggest that the use of cytoflavin during the stages of surgical treatment reduces the number of neurological disorders.

Superficial vs combined cervical plexus block for carotid endarterectomy: a prospective, randomized study

2005 ◽  
Vol 63 ◽  
pp. S22-S25 ◽  
Author(s):  
Atos Alves de Sousa ◽  
Marcos Antônio Dellaretti Filho ◽  
Wilson Faglione ◽  
Gervásio Telles Cardoso Carvalho
Keyword(s):  
Carotid Endarterectomy ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Cervical Plexus ◽  
Cervical Plexus Block ◽  
Plexus Block

Anesthetic Management of Carotid Endarterectomy under Cervical Plexus Block

1998 ◽  
Vol 34 (4) ◽  
pp. 832
Author(s):  
Joung Uk Kim ◽  
Ji Yeon Sim ◽  
Kyoo Sam Hwang ◽  
Young Hi Lee ◽  
Phil Hwan Lee ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Anesthetic Management ◽  
Cervical Plexus ◽  
Cervical Plexus Block ◽  
Plexus Block

Severe dental pain during carotid endarterectomy under cervical plexus block

2001 ◽  
Vol 15 (3) ◽  
pp. 356-357 ◽  
Author(s):  
Samia Madi-Jebara ◽  
Alexandre Yazigi ◽  
Fadia Haddad ◽  
Gemma Hayek
Keyword(s):  
Carotid Endarterectomy ◽  
Dental Pain ◽  
Cervical Plexus ◽  
Cervical Plexus Block ◽  
Plexus Block

Comparison of Clonidine and Epinephrine in Lidocaine for Cervical Plexus Block

1997 ◽  
Vol 22 (2) ◽  
pp. 137-142
Author(s):  
Rowan R. Molnar ◽  
Michael J. Davies ◽  
David A. Scott ◽  
Brendan S. Silbert ◽  
Patricia H. Mooney
Keyword(s):  
Heart Rate ◽  
Carotid Endarterectomy ◽  
Plasma Concentrations ◽  
Prospective Trial ◽  
Onset Time ◽  
Maximum Plasma ◽  
Cervical Plexus ◽  
Double Blind ◽  
Cervical Plexus Block ◽  
Plexus Block

Background and ObjectivesCarotid endarterectomy under cervical plexus block offers the advantage of awake neurologic assessment. The hypothesis was tested that the addition of clonidine 5 μg/mL to lidocaine 1.5% for the block is as effective clinically as the addition of epinephrine 5 μg/mL but without the associated tachycardia.MethodsIn a double-blind, randomized, prospective trial of 40 patients, local anesthetic solutions of lidocaine 1.5% containing either clonidine 5 μg/mL or epinephrine 5 μg/mL were compared for cervical plexus block in patients undergoing carotid endarterectomy. Each solution was administered to 20 patients with a total lidocaine dose of 7 mg/kg. The electrocardiogram, heart rate, and arterial pressure (radial artery catheter) were continuously monitored. Blood samples were drawn for determination of serum lidocaine levels during the first hour.ResultsThe block onset time (8.4 ± 0.6 minutes for epinephrine, 8.8 ± 0.8 minutes for clonidine) and duration (139 ± 6.7 minutes for epinephrine, 148 ± 5.8 minutes for clonidine) were not different between the two groups. During the period from completion of the block until incision there was a significant heart rate increase in the epinephrine group (23% mean rise) as compared with the clonidine group (4% mean rise) (P < .003). There was no difference in blood pressure between the two groups. The maximum plasma concentrations of lidocaine were 2.5-7.6 μg/mL (mean, 4.5 ± 0.3 μg/mL) for the epinephrine group and 4.7-18.4 μg/mL (mean, 7.5 ± 0.7 μg/mL) for the clonidine group (P < .0002). The maximum concentrations were reached 0-30 minutes (mean, 8 ± 1.4 minutes) after injection for the epinephrine group and 0-10 minutes (mean, 4.5 ± 7.1 minutes) for the clonidine group (P < .03).ConclusionsClonidine 5 μg/mL is a useful additive to lidocaine 1.5% for cervical plexus block to reduce the incidence of tachycardia; however, omission of epinephrine results in higher serum lidocaine levels.

Sign in / Sign up

Export Citation Format

Share Document