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Neurological Evaluation by Intraoperative Wake-up During Carotid Endarterectomy Under General Anesthesia

Kitagawa, Norihito MD*; Oda, Mayuko MD*; Kakiuchi, Toshihiko MD*; Taniguchi, Miwa MD*; Totoki, Tadahide MD*; Ohtsubo, Satoshi MD†; Harano, Kiyoshi MD‡

Journal of Neurosurgical Anesthesiology:
Case Report

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.

Author Information

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:

No financial support has been received for this work, including departmental or institutional funding.

© 2004 Lippincott Williams & Wilkins, Inc.