Hemodynamic stability under general anesthesia in carotid artery stenting.
OBJECTIVE
The purpose of our study was to investigate the frequency of hemodynamic instability in patients undergoing carotid artery stenting (CAS) under general anesthesia using sevoflurane and nitrous oxide in oxygen.


METHODS
A total of 97 consecutive CAS procedures were performed in 84 patients under sevoflurane anesthesia. The following hemodynamic variables were assessed: degree of systolic blood pressure change (deltaSBP) during CAS, hypotension, and bradycardia during and after CAS.


RESULTS
During CAS, hypotension occurred in 43% of the patients, and bradycardia occurred in 14%. There was individual variation in the deltaSBP during CAS. Systolic blood pressure (SBP) change >50 mmHg was not seen in this series. After CAS, hypotension occurred in 24%, and bradycardia occurred in 10%. Cerebral infarction occurred in three cases. The stroke rate was 3.1% in this series.


CONCLUSIONS
General anesthesia using sevoflurane and nitrous oxide in oxygen depressed barorecepter reflex sensitivity, induced hemodynamic stability under CAS, and may decrease the rate of occurrence of complications.
Nagata
Shun-ichi
S
Department of Neurosurgery, Fukuoka University Chikushi Hospital, 377-1 Zokumyoin, Chikushino 818-8502, Japan.
Kazekawa
Kiyoshi
K
Aikawa
Hiroshi
H
Tsutsumi
Masanori
M
Kodama
Tomonobu
T
Iko
Minoru
M
Nii
Kohei
K
Matsubara
Shuko
S
Go
Yoshinori
Y
Tanaka
Akira
A
D000368:Aged; D000369:Aged, 80 and over; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects*; D001807:Blood Vessel Prosthesis; D001919:Bradycardia / Q000139:chemically induced* / Q000175:diagnosis; D002339:Carotid Arteries / Q000187:drug effects / Q000601:surgery; D016893:Carotid Stenosis / Q000601:surgery*; D005260:Female; D006487:Hemostasis / Q000187:drug effects; D006801:Humans; D007022:Hypotension / Q000139:chemically induced* / Q000175:diagnosis; D008297:Male; D008738:Methyl Ethers / Q000009:adverse effects*; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000379:methods; D000077149:Sevoflurane; D015607:Stents
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane