Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Choice of anesthesia for carotid endarterectomy: the problemof assessing the risk of perioperative complications and the tacticsof anesthetic management in elderly patient with cardiological anamnesis

Authors: K.A. Kozlova, A.V. Shmigel’skiy, D.Yu. Usachev, V.A. Lukshin, O.M. Zelenkova

Company:
N.N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of the Russian Federation, ul. Chetvertaya Tverskaya-Yamskaya, 16, Moscow, 125047, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2019-16-3-228-234

UDC: 616.133.3:616.147]-053.9-089.87:616.12-089.5:615.849

Link: Clinical Physiology of Blood Circulaiton. 2019; 16 (3): 228-234

Quote as: Kozlova K.A., Shmigel’skiy A.V., Usachev D.Yu., Lukshin V.A., Zelenkova O.M. Choice of anesthesia for carotid endarterectomy: the problem of assessing the risk of perioperative complications and the tactics of anesthetic management in elderly patient with cardiological anamnesis. Clinical Physiology of Circulation. 2019; 16 (3): 228–34 (in Russ.). DOI: 10.24022/1814-6910-2019-16-3-228-234

Received / Accepted:  17.06.2019/02.07.2019

Full text:  

Abstract

The article presents the clinical observation of patient 78 years old, who entered the clinic with a diagnosis of cerebrovascular disease, stenosis of the internal carotid artery. To perform carotid endarterectomy (CEAE), combined anesthesia (CA) was first used: total intravenous anesthesia in combination with regional anesthesia – a superficial and deep blockade of the cervical plexus with local anesthetics. However, during the first hour from the start of induction of anesthesia, the patient developed a stable pharmacoresistant bradiarrhythmia, which required the termination of the operation, transfer of the patient to the intensive care unit. After the stabilization of his condition, the next day there was a reoperation in the regional anesthesia, spontaneous breathing and saved consciousness without any problems. The article discusses the problem of preoperative risk assessment of reoperative complications and indications for the choice of anesthesia method for CEAE.

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About Authors

  • Kseniya A. Kozlova, Anesthesiologist; orcid.org/0000-0002-7142-229X
  • Aleksandr V. Shmigel’skiy, Dr. Med. Sc., Senior Researcher; orcid.org/0000-0002-8349-7707
  • Dmitriy Yu. Usachev, Dr. Med. Sc., Professor, Corresponding Member of the Russian Academy of Sciences, Deputy Director for Research; orcid.org/0000-0003-1520-5650
  • Vasiliy A. Lukshin, Dr. Med. Sc., Associate Professor, Senior Researcher; orcid.org/0000-0001-5787-484X
  • Ol’ga M. Zelenkova, Functional Diagnostician; orcid.org/0000-0002-7579-3258

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