[Perioperative risk factors and anesthetic management of patients for carotid endarterectomy].
Data from the records of 142 patients for carotid endarterectomy at Chugoku Rosai General Hospital between 1983 and 1995, were evaluated concerning perioperative risk factors and anesthetic management. As a preoperative anesthetic risk, the incidence of hypertension was the commonest (76%), and there was a significant incidence of ischemic heart disease (18%). Fentanyl and isoflurane have been used for anesthesia recently and the patients were closely observed and cared in the intensive care unit postoperatively. In order to prevent cerebral ischemia during the occlusion of the internal carotid artery, we measured somatosensory evoked potential as well as jugular venous oxygen saturation, and used near infrared spectophotometry. As a result, postoperative mortality and morbidity were 0% and 2%, respectively. The candidates for CEA have potentially high perioperative risks, and it is important to evaluate the coexisting diseases and to select proper anesthetic technic and monitors.