Characteristics of central hemodynamics and cerebrovascular circulation during various anesthesia modes in reconstructive surgeries for the extracranial vessels].

M I Neĭmark, V V Shmelev, I V Merkulov, A Iu Elizar'ev, I D Raĭkin

Anesteziologiia i reanimatologiia 2010 Jul-Aug

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The purpose of the study was to choose an optimal anesthetic method to ensure adequate cerebral blood flow and to reduce the number of perioperative complications during carotid endarterectomy. Total intravenous anesthesia with diprivan, combined cervical plexus block anesthesia, and inhaled sevoflurane anesthesia were assessed in 190 patients undergoing carotid endarterectomy. The study of cerebral blood flow and central hemodynamic parameters indicated that deprivan anesthesia suppressed the major hemodynamic parameters, causing associated cerebral circulation depression. The use of cervical plexus block as a major component of anesthesia after Pashchuk stabilized the mean blood pressure and cardiac index, causing the optimization of cerebral blood flow parameters with a considerable postload increase. During sevoflurane anesthesia, the most physiological conditions for the performance of the circulatory system were found at all stages of surgical treatment, which predetermined the stable parameters of central hemodynamics and cerebral blood flow. The studies revealed that deprivan anesthesia was followed by a considerable number of both cardiac and neurological complications. The patients with cervical plexus block had fewer neurological disorders, but the increased postload accompanying these changes caused an increase in the number of cardiac complications. The most optimal parameters of cerebral blood flow and central hemodynamics during sevoflurane anesthesia induced a statistically significant reduction in the number of cardiac and neurological complications.

Citation

M I Neĭmark, V V Shmelev, I V Merkulov, A Iu Elizar'ev, I D Raĭkin. Characteristics of central hemodynamics and cerebrovascular circulation during various anesthesia modes in reconstructive surgeries for the extracranial vessels]. Anesteziologiia i reanimatologiia. 2010 Jul-Aug(4):55-63