md-medicaldata

Authors

Dragana Jovanović ^1,2, Rade Vuković ¹, Ivana Nikolić ¹, Nikolina Milošević <sup>2

1</sup>Vojnomedicinska akademija, Klinika za anesteziologiju i intenzivnu terapiju, Beograd / Military Medical Academy, Clinic of Anesthesiology and Critical Care, Belgrade
²Univerzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd / University of Defence, Medical Faculty of the Military Medical Academy, Belgrade

 

UDK: 616.133-089.168
616‑089.5

The paper was received / Rad primljen 27.03.2025.

Accepted / Rad prihvaćen: 21.04.2025.

 

Correspondence to:

Dragana Jovanović
Vojnomedicinska akademija, Beograd, Crnotravska 17
Klinika za anesteziologiju i intenzivnu terapiju
Tel: 063 8528222
e-mail: draganamk@gmail.com

 

 

Sažetak

 

 

Uvod: Karotidna endarterektomija je operacija kojom se prevenira nastanak neurološkog insulta kod pacijenata sa asimptomatskom i simptomatskom visokostepenom stenozom karotidnih arterija. Operacija karotidnih arterija može biti izvedena u opštoj ili regionalnoj anesteziji. Cilj ovog rada je bio da, na osnovu dostupnih podataka iz literature ispita uticaj anesteziološke tehnike na ishod hirurškog lečenja u karotidnoj hirurgiji. Rezultati i diskusija: Obe anesteziološke tehnike imaju određene prednosti i mane. Opšta anestezija je komfornija i manje stresna za pacijenta, ali i za ceo tim, podrazumeva siguran i bezbedan disajni put, kao i kontrolisanu ventilaciju pluća. Glavni nedostatak opšte anestezije predstavlja manje pouzdan neurološki monitoring. Glavna prednost regionalne anestezije je svestan i budan pacijent koji predstavlja egzaktan neurološki monitoring. Tokom operacije u regionalnoj anesteziji pacijent mora mirno da leži na leđima, potrebno je da bude saradljiv i neklaustrofobičan. Zaključak: Pregledom dosadašnjih studija, rezultati nisu pokazali statistički značajnu razliku u nastanku neurološkog insulta, infarkta miokarda ili smrtnog ishoda tokom perioperativnog perioda među pacijentima koji su operisani u opštoj ili regionalnoj anesteziji. Do konačnog odgovora koja je anestezija bolja i sigurnija za karotidnu endarterektomiju, odluku o vrsti anesteziološke tehnike trebalo bi zasnivati na afinitetu i iskustvu hirurga, anesteziologa i želji pacijenta.

 

Ključne reči:

karotidna endarterektomija, anesteziološke tehnike, opšta anestezija, regionalna anestezija

 

 

 

Abstract

 

Introduction: Carotid endarterectomy is a surgery that prevents the occurrence of neurological insult in patients with asymptomatic and symptomatic high-grade carotid artery stenosis. Carotid artery surgery can be performed under general or regional anesthesia. The aim of this study was to, based on available data from the literature, examine the influence of anesthetic techniques on the outcome of surgical treatment. Results and Discussion: Both anesthetic techniques have certain advantages and disadvantages. General anesthesia is more comfortable and less stressful for the patient, as well as for the entire team. It implies a safe and secure airway, along with controlled lung ventilation. The main disadvantage of general anesthesia is the less reliable neurological monitoring. The main advantage of regional anesthesia is a conscious and awake patient, which represents exact neurological monitoring. During the surgery under regional anesthesia, the patient must lie still on his back, be cooperative and non-claustrophobic. Conclusion: The review of previous studies showed results with no statistically significant difference in the occurrence of neurological insult, myocardial infarction or death during the perioperative period among patients who were operated under general versus regional anesthesia. Until it is determined which anesthesia is better and safer for carotid endarterectomy, the decision about the type of anesthesia technique should be based on surgeon’s and anesthesiologist’s affinity and experience, and the patient's wishes.

 

Key words:

carotid endarterectomy, anesthetic techniques, general anesthesia, regional anesthesia.

 

 

 

 

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