2Konya Meram Eğitim ve Araştırma Hastanesi, Anestezi ve Reanimasyon Uzmanı KONYA Introduction: Carotid surgery is an important operation in terms of both intraoperative stroke risk and postoperative respiratory functions in patients with carotid artery stenosis requiring surgical treatment, and having comorbidities such as advanced age and chronic obstructive pulmonary disease. In this study, we retrospectively investigated whether carotid endarterectomy with conscious technique is an effective method in patients with comorbidities such as old age and chronic obstructive lung disease.
Materials and Method: Carotid endarterectomy with conscious technique was performed in 21 patients between February 2008 and August 2010. Four of the patients were female and 17 were male; the mean age was 72.3+5.1 years (range of 69-83 years). All patients underwent carotid endarterectomy under cervical blockage. A shunt was placed when needed and consciousness and movements of muscle strength were checked intermittently during the operation.
Results: An intraoperative shunt had to be placed in one patient. This patient developed postoperative hemiparesis and fully recovered with medical care. One patient developed difficulty in swallowing due to paralysis of N. Hypoglossus and improved with medical therapy. One patient with carotid and coronary lesions was scheduled to undergo a two-staged surgery and died from myocardial infarction following the carotid operation. All other patients fully recovered and were discharged.
Conclusion: Carotid endarterectomy with conscious technique greatly benefits patients by allowing close intraoperative motor and mental monitoring and by providing protection against complications of intubation in patients of advanced age with comorbidities such as chronic lung disease.
Keywords : Endarterectomy, Carotid; Conscious Sedation; Aged; Pulmonary Disease, Chronic obstructive