Physiological advantages of cerebral blood flow during carotid endarterectomy under local anaesthesia. A randomised clinical trial

European Journal of Vascular and Endovascular Surgery

Volumn 24, Issue 3, 2002, Pages 215-221

  McCarthy, R J ^a   Nasr, M K ^a   McAteer, P ^a   Horrocks, M ^a  

^a ROYAL UNITED HOSPITAL   (United Kingdom)

Author keywords

Carotid endarterectomy; Cerebral blood flow

Indexed keywords

BUPIVACAINE; LIDOCAINE; MIDAZOLAM; PROMETHAZINE; TEMAZEPAM; ANESTHETIC AGENT; LOCAL ANESTHETIC AGENT;

AGED; ARTERY CLAMP; ARTICLE; BRAIN ARTERY; BRAIN BLOOD FLOW; BRAIN CIRCULATION; CAROTID ENDARTERECTOMY; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DOPPLER ECHOGRAPHY; FEMALE; GENERAL ANESTHESIA; HUMAN; LOCAL ANESTHESIA; MAJOR CLINICAL STUDY; MALE; MEAN ARTERIAL PRESSURE; MIDDLE CEREBRAL ARTERY; MORTALITY; POSTOPERATIVE COMPLICATION; PREOPERATIVE EVALUATION; PRESSURE TRANSDUCER; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; STROKE; BLOOD FLOW VELOCITY; BLOOD PRESSURE; CAROTID ARTERY DISEASE; COMPARATIVE STUDY; DRUG EFFECT; PATHOPHYSIOLOGY; PHYSIOLOGY; PROSPECTIVE STUDY;

AGED; ANESTHESIA, GENERAL; ANESTHESIA, LOCAL; ANESTHETICS, GENERAL; ANESTHETICS, LOCAL; BLOOD FLOW VELOCITY; BLOOD PRESSURE; CAROTID ARTERY DISEASES; CEREBROVASCULAR CIRCULATION; ENDARTERECTOMY, CAROTID; FEMALE; HUMANS; MALE; MIDDLE CEREBRAL ARTERY; PROSPECTIVE STUDIES;

EID: 0036717933     PISSN: 10785884     EISSN: 15322165     Source Type: Journal    
DOI: 10.1053/ejvs.2002.1715     Document Type: Article

References (21)

1. MURIE JA, JOHN TG, MORRIS PJ. Carotid endarterectomy in Great Britain and Ireland: practice between 1984 and 1992. Br J Surg 1994; 81: 827-831.
2. STONEHAM MD, KNIGHTON JD. Regional anaesthesia for carotid endarterectomy (see comments). Anaesthesia 2000; 55: 481-485.
3. TANGKANAKUL C, COUNSELL C, WARLOW C. Local versus general anaesthesia for carotid endarterectomy. Cochrane Database Syst Rev 2000: CD000126.
4. MCCLEARY AJ, DEARDEN NM, DICKSON DH, WATSON A, GOUGH MJ. The differing effects of regional and general anaesthesia on cerebral metabolism during carotid endarterectomy. Eur J Vasc Endovasc Surg 1996; 12: 173-181.
5. NAYLOR AR, WILDSMITH JA, MCCLURE J, JENKINS AM, RUCKLEY CV. Transcranial Doppler monitoring during carotid endarterectomy. Br J Surg 1991; 78: 1264-1268.
6. JORGENSEN LG, SCHROEDER TV. Transcranial Doppler for carotid endarterectomy. Eur J Vasc Endovasc Surg 1996; 12: 1-2.
7. HALSEY JH, MCDOWELL HA, GELMON S, MORAWETZ RB. Blood velocity in the middle cerebral artery and regional cerebral blood flow during carotid endarterectomy. Stroke 1989; 20: 53-58.
8. BASS A, KRUPSKI WC, SCHNEIDER PA, OTIS SM, DILLEY RB, BERNSTEIN EF. Intraoperative transcranial Doppler: limitations of the method. J Vasc Surg 1989; 10: 549-553.
9. SCHNEIDER PA, ROSSMAN ME, TOREM S, OTIS SM, DILLERY RB, BERNSTEIN EF. Transcranial Doppler in the management of extracranial cerebrovascular disease: implications in diagnosis and monitoring. J Vasc Surg 1988; 7: 223-231.
10. MCCARTHY RJ, MCCABE AE, WALKER R, HORROCKS M. The value of transcranial Doppler in predicting cerebral ischaemia during carotid endarterectomy. Eur J Vasc Endovasc Surg 2001; 21: 408-412.
11. BEARD J. Should all patients be shunted? If not, how can I predict which patients will require a shunt? In: Naylor AR, ed. Carotid Artery Surgery. A Problem Based Approach. London: WB Saunders, 2000; 244-247.
12. COUNSELL C, SALINAS R, NAYLOR R, WARLOW C. Routine or selective carotid artery shunting for carotid endarterectomy (and different methods of monitoring in selective shunting). Cochrane Database Syst Rev 2000: CD000190.
13. HALSEY JH JR. Risks and benefits of shunting in carotid endarterectomy. The International Transcranial Doppler Collaborators. Stroke 1992; 23: 1583-1587.
14. SUNDT T, SHARBROUGH F, MARSH W, EBERSOLD M, PIEPGRAS DG, MESSICK J. The risk-benefit ratio of intraoperative shunting during carotid endarterectomy. Ann Surg 1986; 203: 196-204.
15. EVANS WE, HAYES JP, WALTKE EA, VERMILION BD. Optimal cerebral monitoring during carotid endarterectomy: neurologic response under local anesthesia. J Vasc Surg 1985; 2: 775-777.
16. IMPARATO AM, RAMIREZ A, RILES T, MINTZER R. Cerebral protection in carotid surgery. Arch Surg 1982; 117: 1073-1078.
17. BENJAMIN ME, SILVA MB JR, WATT C, MCCAFFREY MT, BURFORD-FOGGS A, FLINN WR. Awake patient monitoring to determine the need for shunting during carotid endarterectomy. Surgery 1993; 114: 673-679; discussion 673-681.
18. HAYES PD, VAINAS T, HARTLEY S et al. The Pruitt-Inahara shunt maintains mean middle cerebral artery velocities within 10% of preoperative values during carotid endarterectomy. J Vasc Surg 2000; 32: 299-306.
19. FORSSELL C, TAKOLANDER R, BERGQVIST D, JOHANSSON A, PERSSON NH. Local versus general anaesthesia in carotid surgery. A prospective, randomised study. Eur J Vasc Surg 1989; 3: 503-509.
20. MCCLEARY AJ, MARITATI G, GOUGH MJ. Carotid endarterectomy; local or general anaesthesia? Eur Vasc Endovasc Surg 2001; 22: 1-12.
21. SBARIGIA E, DARIOVIZZA C, ANTONINI M et al. Locoregional versus general anesthesia in carotid surgery: is there an impact on perioperative myocardial ischemia? Results of a prospective monocentric randomized trial. Circulation 1998; 97: 501-509.