Hemodynamics and jugular venous oxygen saturation during carotid endarterectomy: a comparison between general and locoregional anesthesia

TY - JOUR

T1 - Hemodynamics and jugular venous oxygen saturation during carotid endarterectomy: a comparison between general and locoregional anesthesia

AU - Dias, N V

AU - Kölbel, T

AU - Gonçalves, I

AU - Chew, M

AU - Wistrand, J

AU - Brunkwall, P S

PY - 2010/6

Y1 - 2010/6

N2 - AIM: To study hemodynamic and blood oxygenation changes in patients undergoing carotid endarterectomy (CEA) under general (GA) or locoregional (LRA) anesthesia.METHODS: Prospective non-randomized study including 50 patients undergoing CEA (31 men, mean age 72 (range 50-84) years-old under GA (N.=23) or LRA (N.=27). Systemic blood pressure, ECG, venous oxygen saturation in the ipsilateral jugular bulb and pulse-oximetry were monitored. Blood-gas analysis was done from blood obtained from the radial artery and ipsilateral jugular vein.RESULTS: Pulse rate and systemic systolic blood pressure were higher in LRA compared to the GA before, during and after cross clamping (P<0.05). Seven GA patients required dopamine-infusion to maintain systolic blood pressure >120 mmHg. Jugular venous saturation was initially identical in both groups, but decreased significantly upon cross clamping in LRA compared to GA (P<0.05). This difference remained at least 3 minutes after cross clamp release (P<0.05).CONCLUSION: Patients under LRA seem to have increased sympathetic activity compared to patients under GA, as expressed by higher pulse rates and systolic blood pressures. Jugular venous saturation was lower during clamping of LRA patients. The differences were small and concur with the near-equality findings in studies analysing the clinical outcome.

AB - AIM: To study hemodynamic and blood oxygenation changes in patients undergoing carotid endarterectomy (CEA) under general (GA) or locoregional (LRA) anesthesia.METHODS: Prospective non-randomized study including 50 patients undergoing CEA (31 men, mean age 72 (range 50-84) years-old under GA (N.=23) or LRA (N.=27). Systemic blood pressure, ECG, venous oxygen saturation in the ipsilateral jugular bulb and pulse-oximetry were monitored. Blood-gas analysis was done from blood obtained from the radial artery and ipsilateral jugular vein.RESULTS: Pulse rate and systemic systolic blood pressure were higher in LRA compared to the GA before, during and after cross clamping (P<0.05). Seven GA patients required dopamine-infusion to maintain systolic blood pressure >120 mmHg. Jugular venous saturation was initially identical in both groups, but decreased significantly upon cross clamping in LRA compared to GA (P<0.05). This difference remained at least 3 minutes after cross clamp release (P<0.05).CONCLUSION: Patients under LRA seem to have increased sympathetic activity compared to patients under GA, as expressed by higher pulse rates and systolic blood pressures. Jugular venous saturation was lower during clamping of LRA patients. The differences were small and concur with the near-equality findings in studies analysing the clinical outcome.

KW - Aged

KW - Aged, 80 and over

KW - Anesthesia, Conduction

KW - Anesthesia, General

KW - Blood Pressure

KW - Cardiotonic Agents/administration & dosage

KW - Carotid Stenosis/blood

KW - Constriction

KW - Dopamine/administration & dosage

KW - Endarterectomy, Carotid

KW - Female

KW - Heart Rate

KW - Hemodynamics

KW - Humans

KW - Jugular Veins

KW - Male

KW - Middle Aged

KW - Oximetry

KW - Oxygen/blood

KW - Prospective Studies

KW - Severity of Illness Index

KW - Sympathetic Nervous System/physiopathology

KW - Time Factors

KW - Treatment Outcome

M3 - SCORING: Journal article

C2 - 20502409

VL - 29

SP - 232

EP - 238

JO - INT ANGIOL

JF - INT ANGIOL

SN - 0392-9590

IS - 3

ER -