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Korean Journal of Anesthesiology 2006;51(5):651-654.
DOI: https://doi.org/10.4097/kjae.2006.51.5.651   
Hemodynamic Profile of Carotid Sinus Nerve Blockade on Hypotension Occurred Immediately after Carotid Endarterectomy Declamping: A case report.
Su Jin Kang, Won Jung Shin, Gyu Sam Hwang
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. kshwang@amc.seoul.kr
Carotid sinus nerve blockade (CSNB) has been shown to be effective for management of post-carotid endarterectomy (CEA) hypotension. The underlying hemodynamic changes are unknown. We retrospectively analyzed a recorded arterial blood pressure (ABP) waveform using a Modelflow technique. After declamping, total peripheral resistance (TPR) decreased (-65% of predeclamping value), but cardiac output (CO) and stroke volume (SV) increased (+60 and +57% of predeclamping value, respectively). CSNB abruptly increased blood pressure (BP) and TPR (75 and 95% of nadir, respectively), while CO and SV gradually decreased to -21 and -16% of maximum value, respectively). In conclusion, we found that severe decline of TPR was a cause of severe hypotension after declamping and CSNB increased BP mainly through increase in TPR, with little change in CO and SV.
Key Words: carotid sinus nerve blockade; hemodynamic profile


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