REGIONAL ANESTHESIA IN CONDITIONS OF PRESERVED CONSCIOUSNESS AND SPONTANEOUS RESPIRATION IN ELDERLY PATIENT OPERATED ON THE CREATION OF EXTRACRANIAL TO INTRACRANIAL BYPASS (CLINICAL OBSERVATION)
The article provides an example of successful surgical treatment of a 81 years-patient with symptomatic occlusion of the internal carotid artery (ICA) leading to severe violations of cerebral hemodynamics and accompanied by syncope, severe disorders of gait and static. Given the patient’s age and somatic burdened history, operation was performed on the creation of extracranial to intracranial (EC-IC) bypass in the context of regional anesthesia (RA), spontaneous breathing and preserved consciousness. In the postoperative period pronounced clinical effect was obtained in the form of a full recourse syncope and gait disorders in the background restoring of cerebral perfusion in the pool right middle cerebral artery. The article discusses the indications for surgical treatment and the choice of anesthetic technique, especially the performance of the RA and technical details of the operation on creation of EC\IC bypass.
About the authorsShmigel‘skiy Aleksandr V.
Kaku Y., Yamashita K., Kokuzawa J. et al. Superficial temporal artery-middle cerebral artery bypass using local anesthesia and a sedative without endotracheal general anesthesia. J. Neurosurg. 2012; 117: 288-94.
Blair G.W., Doubal F.N., Thrippleton M.J. et al. Magnetic resonance imaging for assessment of cerebrovascular reactivity in cerebral small vessel disease: A systematic review. J. Cereb. Blood Flow Metab. 2016, 36 (5): 833-41.
Vilela M.D., Newell D.W. Superficial temporal artery to middle cerebral artery bypass: past, present and future. Neurosurg. Focus. 2008; 24 (2).
Grubb R.L. Jr., Powers W.J. et al. Surgical results of the Carotid Occlusion Surgery Study. J. Neurosurg. 2013; 118: 25-33.
Lukshin V.A., Usachev D.Yu., Pronin I.N., Akhmedov A.D., Schul’tz E.I. Perfusion criteria of the EICMA efficacy in patients with symptomatic occlusion of the internal carotid artery. Zhurn. “Vopr. neyrokhir.” im. N.N. Burdenko. 2016; (5): 67-77. (in Russian)
Reynolds M.R., Grubb R.L. et al. Investigating the mechanisms of perioperative ischemic stroke in the Carotid Occlusion Surgery Study. J. Neurosurg. 2013; 119: 988-95.
Derdeyn C.P. - Cerebral hemodynamics in carotid occlusive disease. Am. J. Neuroradiol. 2003; 15 (2): 341-50.
Licker M. Regional or general anaesthesia for carotid endarterectomy. Does it matter? Eur. J. Anaesthesiol. 2016; 33: 241-3.
- Refbacks are not listed
Контент доступен под лицензией Creative Commons Attribution 3.0 License.