title: [Carotid endarterectomy: evaluation of a "combined" technique of general anesthesia].
abstract: BACKGROUND
  The literature suggests several techniques to ensure the optimal anesthetic procedure for carotid surgery. The aim of our study is to combine, in the carotid endarterectomy, a model of general anesthesia with the loco-regional anesthesia in order to test the safety of the method, the eventual brain damage and hemodynamic stability. We also wanted to test whether the immediate postoperative analgesia was adequate.
  
  
  METHODS
  Seventy eight (78) patients were enrolled in the study (from 60 to 75 years), ASA II-III, candidates for unilateral carotid endarterectomy in a period from June 2008 to January 2009. During the procedure data about perioperative neurologic and hemodynamic complications were collected. At the end of the surgical treatment the pain at the awakening moment through verbal numerical scale VNS was estimated. Data are presented as mean values +/- sd and validated using the chi2 test, when required. Significance was accepted at a value of P < or = 0.05.
  
  
  RESULTS
  85% of patients reported a VNS between 1 and 2 and 10% equal to 3-5. In the study 95% of patients (P<0.05) appreciated the technique and only 3 patients reported their dissatisfaction. There was no mortality and in 5 patients a postoperative morbidity was registered.
  
  
  CONCLUSIONS
  The study demonstrated the advantages in combining loco-regional anesthesia (valid monitoring of neurological and hemodynamic stability) with general anesthesia (complete airways control and patient comfort) during carotid surgery.
authors.affiliation: Università "La Sapienza", Roma.
authors.forename: Letizia
authors.initials: L
authors.lastname: Leogrande
authors.forename: Marco
authors.initials: M
authors.lastname: Aversano
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Tellan
authors.forename: Antonio
authors.initials: A
authors.lastname: Menichetti
authors.forename: Giorgio
authors.initials: G
authors.lastname: Di Rocco
authors.forename: Andrea
authors.initials: A
authors.lastname: Redler
authors.forename: Francesca
authors.initials: F
authors.lastname: Frezzotti
authors.forename: Adriano
authors.initials: A
authors.lastname: Redler
authors.forename: Alain
authors.initials: A
authors.lastname: Muhindo
authors.forename: Giovanna
authors.initials: G
authors.lastname: Delogu
mesh_terms: D000368:Aged; D000765:Anesthesia, Conduction; D000768:Anesthesia, General; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged