Korean J Anesthesiol.  1988 Jun;21(3):497-501. 10.4097/kjae.1988.21.3.497.

Anesthetic Management for Carotid Artery Surgery with a Temporary Indwelling Shunt

• Lee KM
• Kim WO
• Shin YS
• Nam YT
• Park KW

• KMID: 2116503
• DOI: http://doi.org/10.4097/kjae.1988.21.3.497

Abstract

A 24 years old female patient presented for surgical resection of a large chemodectoma with extensive involvement of the bifurcation of the left common carotid artery. Anesthesia was induced with thiopental and maintained with 0.75~1.25% halothane with 50% nitrous oxide in oxygen. Arterial blood pressure and carbon dioxide tension were maintained at preoperative levels with a direct arterial pressure monitoring device and an ABM end-tidal carbon dioxide monitoring device. Thiopental was infused continuously by a microinfusion pump(2mg/kg/hr) during the procedure and an intraluminal shunt was inserted in the left internal carotid artery to protect the brain form hypoxic attack. Body temperature was monitored and electrocardiography and electroencephalography were also applied. No significant changes in vital signs and electroencephalgraphy during anesthesia were noted with the exception of a temporary decreas in blood pressure due to bleeding from the accidental perforation of the left internal carotid artery. The patient responded soon after the withdrawal of anesthesia and she was discharged from hospital with an uneventful recovery on the seventh postoperative day. A reduction in cerebral blood flow without a concomitant reduction in cerebral metabolic rate during carotid arterial procedures may result in significant neurologic derangements. Therefore, the major role of the anesthesiologist is the maintenance of adequate oxygen delivery to the brain and the reduction of cerebral metabolic demands.

Keyword

Carotid artery surgery; Shunt; Chemodectoma

MeSH Terms

Anesthesia
Arterial Pressure
Blood Pressure
Body Temperature
Brain
Carbon Dioxide
Carotid Arteries*
Carotid Artery, Common
Carotid Artery, Internal
Electrocardiography
Electroencephalography
Female
Halothane
Hemorrhage
Humans
Nitrous Oxide
Oxygen
Paraganglioma, Extra-Adrenal
Thiopental
Vital Signs
Young Adult
Carbon Dioxide
Halothane
Nitrous Oxide
Oxygen
Thiopental