Although general anesthesia allows relief from stressors such as pain, discomfort, or anxiety for patients undergoing carotid endarterectomy, neurologic assessment is less reliable than under local anesthesia. We describe a unique anesthetic management strategy for carotid endarterectomy patients incorporating the advantages of both general and local anesthesia. The technique allows thorough assessment of neurologic function during carotid cross-clamping by intraoperative wake-up, and guarantees airway management by tracheal intubation.
From the Departments of *Anesthesiology and †Cardiovascular Surgery, Saga Medical School, Nebeshima, Saga; and ‡West Japan Pain Clinic, Fukuoka, Japan.
Received for publication November 11, 2003; accepted January 21, 2004.
Reprints: Norihito Kitagawa, MD, Department of Anesthesiology, Saga Medical School, Nabeshima, Saga, 849-8501, Japan (e-mail: firstname.lastname@example.org).
No financial support has been received for this work, including departmental or institutional funding.