Skip to main content
SpringerLink
Log in
Book cover

Anästhesie und kardiovaskuläres System pp 234–244Cite as

Überwachungs- und Anästhesieprobleme bei der Karotischirurgie

  • Chapter

Part of the book series: Klinische Anästhesiologie und Intensivtherapie ((KAI,volume 41))

Zusammenfassung

Kardiale und neurologische Komplikationen sind die Hauptursachen der peri-operativen Morbidität und Mortalität nach operativen Eingriffen an der A. carotis. Bleibende neurologische Schäden und Myokardinfarkte treten in einer Häufigkeit von je 1–3% auf [11, 29]. Die hohe Rate kardialer Zwischenfälle ist dadurch begründet, daß die Arteriosklerose der hirnversorgenden Arterien, derentwegen eine Karotisendarterektomie durchgeführt wird, in der Regel keine isolierte Erkrankung, sondern nur eine Erscheinungsform einer Systemerkrankung aller Gefäße ist. Dementsprechend häufig finden sich unter den Patienten solche mit einem fortgeschrittenen Alter und einer Reihe von Begleiterkrankungen, insbesondere des Herz-Kreislauf-Systems.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Astrup J, Symon L, Branston NM, Lassen NA (1977) Cortical evoked potential and extracellular K+ and H+ at critical levels of brain ischemia. Stroke 8: 51

    Article  PubMed  CAS  Google Scholar 

  2. Beebe HG, Starr C, Slack D (1989) Carotid artery stump pressure: its variability when measured serially. J Cardiovasc Surg 30: 419

    CAS  Google Scholar 

  3. Blume WT, Ferguson GG, McNeill DK (1986) Significance of EEG changes at carotid endarterectomy. Stroke 17: 891

    Article  PubMed  CAS  Google Scholar 

  4. Boysen G (1973) Cerebral hemodynamics in carotid surgery. Acta Neurol Scand [Suppl] 49: 52

    Google Scholar 

  5. Branston NM, Symon L, Crockard HA, Pasztor E (1974) Relationship between the cortical evoked potential and local cortical blood flow following acute middle cerebral artery occlusion in the baboon. Exp Neurol 45: 195

    Article  PubMed  CAS  Google Scholar 

  6. Buche M, Greniere Y, Schoevaerdts JC, Jaumin P, Ponlot R, Chalant CH (1988) Comparative results after endarterectomy of the internal carotid artery performed with or without a shunt. J Cardiovasc Surg 29: 428

    CAS  Google Scholar 

  7. Burmeister W, Doerrler J, Maurer PC, Mix C (1987) Transcranielles Dopplermonitoring bei rekonstruktiven Eingriffen an der Carotisgabel. Angio 9: 231

    Google Scholar 

  8. Cole DJ, Drummond JC, Ruta TS, Ghazal BS, Osborne T (1990) Hemodilution and hypertension increase cerebral hemorrhage following focal cerebral ischemia in rats. Anesth Analg [Suppl] 70: 66

    Article  Google Scholar 

  9. Cucchiara RF, Sundt TM, Michenfelder JD (1988) Myocardial infarction in carotid endarterectomy patients anesthetized with halothanc, enflurane, or isoflurane. Anesthesiology 69: 783

    Article  PubMed  CAS  Google Scholar 

  10. Dinkel M, Kamp HD, Schweiger H (1991) Somatosensorisch evotierte Potentiale in der Karotischirurgie. Anaesthesist 40: 72

    PubMed  CAS  Google Scholar 

  11. Fitch W (1976) Anaesthesia for carotid artery surgery. Br J Anaesth 48: 65

    Article  Google Scholar 

  12. Fourcade HE, Larson CP, Ehrenfeld WK, Hickey RF, Newton TH (1970) The effects of CO2 and systemic hypertension on cerebral perfusion pressure during carotid endarterectomy. Anesthesiology 33: 383

    Article  PubMed  CAS  Google Scholar 

  13. Gelb AW (1984) Anesthetic considerations for carotid endarterectomy. Int Anesthesiol Clin 22: 153

    PubMed  CAS  Google Scholar 

  14. Gigli GL, Caramia M, Marciani MG, Zarola F, Lavaroni F, Rossini PM (1987) Monitoring of subcortical and cortical somatosensory evoked potentials during carotid endarterectomy. comparison with stump pressure levels. Electroencephalogr Clin Neurophysiol 68: 424

    Article  PubMed  CAS  Google Scholar 

  15. Hafner CD, Evans WE (1988) Carotid endarterectomy with local anesthesia: Results and advantages. J Vasc Surg 7: 232

    PubMed  CAS  Google Scholar 

  16. Hoffman WE, Braucher E, Pelligrino DA, Thomas C, Albrecht RF, Miletich DJ (1990) Brain lactate and neurologic outcome following incomplete ischemia in fasted, nonfasted, and glucose-loaded rats. Anesthesiology 72: 1045

    Article  PubMed  CAS  Google Scholar 

  17. Jakobs LA, Brinkman SD, Morrell RM, Shirley JG, Ganji S (1983) Long-latency somatosensory evoked potentials during carotid endarterectomy. Am Surg 49: 338

    Google Scholar 

  18. Larson CP, Ehrenfeld WK, Wade JG, Wylie EJ (1967) Jugular venous oxygen saturation as an index of adequacy of cerebral oxygenation. Surgery 62: 31

    Google Scholar 

  19. Markand ON, Dilley RS, Moorthy SS, Warren C (1984) Monitoring of somatosensory evoked responses during carotid endarterectomy. Arch Neurol 41: 375

    Article  PubMed  CAS  Google Scholar 

  20. Messick JM, Casement B, Sharbrough FW, Milde LN, Michenfelder JD, Sundt TM (1987) Correlation of regional cerebral blood flow (rCBF) with EEG changes during isoflurane anesthesia for carotid endarterectomy. Critical rCBF. Anesthesiology 66: 344

    Article  PubMed  Google Scholar 

  21. Modica PA, Tempelhoff R (1989) A comparison of computerized EEG with internal carotid artery stump pressure for detection of ischemia during carotid endarterectomy. J Neurosurg Anesthesiol 1: 211

    Article  PubMed  CAS  Google Scholar 

  22. Morawetz RB, Zeiger HE, McDowell HA, McKay RD, Varner PD, Gelman S, Halsey JH (1984) Correlation of cerebral blood flow and EEG during carotid occlusion for endarterectomy (without shunting) and neurologic outcome. Surgery 96: 184

    PubMed  CAS  Google Scholar 

  23. Pasch T (1982) Anästhesie bei der Karotischirurgie. Anästh Intensivmed 23: 114

    Google Scholar 

  24. Peitzman AB, Webster MW, Loubeau JM, Grundy BL, Bahnson HT (1982) Carotid endarterectomy under regional (conductive) anesthesia. Ann Surg 196: 59

    Article  PubMed  CAS  Google Scholar 

  25. Pozzessere G, Valle E, Santoro A, Delfini R, Rizzo PA, Cantore GP, Morocutti C (1987) Prognostic value of early somatosensory evoked potentials during carotid surgery: relationship with electroencephalogram, stump pressure and clinical outcome. Acta Neurochir 89: 28

    Article  CAS  Google Scholar 

  26. Schweiger H, Kamp HD, Dinkel M (1991) Somatosensory evoked potentials during carotid artery surgery: Experience in 400 operations. Surgery 109: 602

    PubMed  CAS  Google Scholar 

  27. Smith JS, Roizen MF, Cahalan MK et al. (1988) Does anesthetic technique make a difference? Augmentation of systolic blood pressure during carotid endarterectomy: Effects of phenylphrine versus light anesthesia and of isoflurane versus halothane on the incidence of myocardial ischemia. Anesthesiology 69: 846

    Article  PubMed  CAS  Google Scholar 

  28. Steed DL, Peitzman AB, Grundy BL, Webster MW (1982) Causes of stroke in carotid endarterectomy. Surgery 92: 634

    PubMed  CAS  Google Scholar 

  29. Sundt TM, Ebersold MJ, Sharbrough FW, Piepgras DG, Marsh WR, Messick JM (1986) The risk-benefit ratio of intraoperative shunting during carotid endarterectomy. Ann Surg 203: 196

    Article  PubMed  Google Scholar 

  30. Symon L (1985) Flow thresholds in brain ischaemia and the effects of drugs. Br J Anaesth 57: 34

    Article  PubMed  CAS  Google Scholar 

  31. Wade JG (1977) Carotid endarterectomy. The anesthetic challenge. (ASA 28th Annual Refresher Course Lectures, no 218 )

    Google Scholar 

  32. Whitney DG, Kahn EM, Estes JW, Jones CE (1980) Carotid artery surgery without a temporary indwelling shunt. Arch Surg 115: 1393

    Article  PubMed  CAS  Google Scholar 

  33. Young WL, Prohovnik I, Correll JW, Ornstein E, Matteo RS, Ostapkovich N (1989) Cerebral blood flow and metabolism in patients undergoing anesthesia for carotid endarterectomy. Anesth Analg 68: 712

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. H.-D. Kamp
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Dinkel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. Schweiger
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Institut für Anästhesiologie, Universitätsspital, Rämistraße 100, CH-8091, Zürich, Österreich

    T. Pasch  & Edith R. Schmid  & 

Rights and permissions

Reprints and permissions

Copyright information

© 1991 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Kamp, HD., Dinkel, M., Schweiger, H. (1991). Überwachungs- und Anästhesieprobleme bei der Karotischirurgie. In: Pasch, T., Schmid, E.R. (eds) Anästhesie und kardiovaskuläres System. Klinische Anästhesiologie und Intensivtherapie, vol 41. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-51139-4_20

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-51139-4_20

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-54340-4

  • Online ISBN: 978-3-642-51139-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation