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Korean J Anesthesiol > Volume 21(3); 1988 > Article
Korean Journal of Anesthesiology 1988;21(3):497-501.
DOI: https://doi.org/10.4097/kjae.1988.21.3.497   
Anesthetic Management for Carotid Artery Surgery with a Temporary Indwelling Shunt.
Kyoung Min Lee, Won Oak Kim, Yang Sik Shin, Yong Taek Nam, Kwang Won Park
Department of Anesthesiology, Yonsei University College of Medicine, Seoul, Korea.
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.
Key Words: Carotid artery surgery; Shunt; Chemodectoma
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