Arterial pressure management and carotid endarterectomy.

Abstract:

:Acute perioperative changes in arterial pressure occur frequently, particularly in patients with cardiovascular disease or those receiving vasoactive medications, or in relation to certain cardiovascular surgical procedures. Both hypo- and hypertension are common in patients undergoing carotid surgery because of unique patho-physiological and surgical factors. Poor arterial pressure control is associated with increased morbidity and mortality after carotid endarterectomy, but good control of arterial pressure is often difficult to achieve in practice. New guidelines have emphasized the benefits of performing carotid surgery urgently in patients with acute neurological symptoms. This strategy may make perioperative arterial pressure control more challenging. However, few specific data are available to guide individual drug therapy. The incidence, implications, and aetiology of haemodynamic instability associated with carotid surgery are reviewed, and some recommendations made for its management. Close monitoring and titration of therapy are probably the most important considerations rather than specific choice of agents.

journal_name

Br J Anaesth

authors

Stoneham MD,Thompson JP

doi

10.1093/bja/aep012

subject

Has Abstract

pub_date

2009-04-01 00:00:00

pages

442-52

issue

4

eissn

0007-0912

issn

1471-6771

pii

S0007-0912(17)34465-3

journal_volume

102

pub_type

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