Comparation of influence general and regional anesthesia on basic haemodynamic parameters during carotid endarterectomy

Carotid endarterectomy (CEA) is a preventive operation to reduce the incidence of embolic and thrombotic cerebral stroke. CEA carries a significant perioeperartive mortality rate from stroke and myocardial infarction, which may even approach 5%. Thus, anesthetic and surgical techniques are constantly under scrutiny to try to reduce this relatively high incidence of morbidity and mortality. Anesthetic technique for CEA is divided to general (GA) and regional (RA) anesthesia, performed by cervical plexus block. The aim this study was to examine changes of basic haemodynamic parameters, which routinely fallows during CEA in condition of GA and RA. After obtaining institutional approval and informed consent, we randomized 50 patients scheduled for CEA (Tab.1) in two groups (GA and RA). We fallow blood pressure: systolic (BPs), mean (BPm), diastolic (BPd), heart rate (HR), and RPP index at the examined patients. The examination performed in six control times: before induction of anesthesia (T1), 10 minutes after beginning of operation (T2), 5 minutes after cross clamping of arteria carotis (T3), 5 minutes after declamping arteria carotis (T4), 10 minutes (T5) and 2 hours after operation (T6). The results of study shows significant changes of blood pressure (BPs and BPm) and RPP index in T2 time in patinets undergoing GA. The changes occurred under influence of induction agent thio- pental. These changes were in homeostatic range. In RA patinets, no haemodynamic changes registrated in control times. Therefore, from haemodynamic aspect RA was superior to GA. Karotidna endarterektomija (CEA) je preventivna operacija kojom se smanjuje ucestalost mordanih embolija i inzulta. Operacija CEA je pracena znacajnom ucestaloscu moratliteta usled mozdanog inzulta i miokardijalnog infarkta koji se priblizava vrednostima od oko 5%. Stoga se anestezioloska i hirurska tehnika stalno preispituje ciljem da se smanji relativno visoka ucestalost morbiditeta i mortaliteta. Anestezioloka tehnika za CEA je podeljena na optu (OA) i regionalnu (RA) anesetziju, se sprovodi primenom cervikalnog bloka. Cilj studije je bio bio da se ispitaju promene osnovnih hemodinamskih parmetara u uslovima OA i RA, koji se prate rutinski tokom CEA. Posle dobijanja klinicke saglasnosti i saglasnosti bolesnika za izvodjenje studije, 50 bolesnika planiranih za CEA (Tabela 1) smo randomizirali u dve grupe (OA i RA). Kod ispitivanih bolesnika su precene vrednosti krvnog pritiska: sistolnog (KPs), srednjeg (KP