Why the study?
Does hypocarbic general anesthesia reduce postoperative neurological deficit compared to hypercarbic general anesthesia in patients undergoing carotid endarterectomy?
Does hypocarbic general anesthesia reduce postoperative neurological deficit compared to hypercarbic general anesthesia in patients undergoing carotid endarterectomy?
In patients undergoing carotid endarterectomy, hypocarbia did not significantly reduce postoperative neurological deficits compared to hypercarbia, but hypercarbia was associated with increased intraoperative arrhythmias.
Hypocarbia does not significantly reduce neurological deficits after carotid endarterectomy; leaves optimal CO2 management unresolved for future trials.
One hundred consecutive patients were randomly given hypocarbic (PaCO2 less than 25 torr) or hypercarbic (PaCO2 greater than 60 torr) general anesthesia during carotid endarterectomy to test the effect of the two regimens upon the incidence of postoperative neurological deficit. An indwelling shunt was not used. One patient died, two have permanent neurological deficits and two have temporary neurological deficits. Although hypocarbic patients had fewer neurological complications than hypercarbic patients, the difference was not statistically significant (p less than 0.13). Hypercarbia significantly increased the incidence of intraoperative arrhythmia. Also, no relationship was found between the incidence of postoperative stroke and the internal carotid back pressure or the time of carotid occlusion.
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Baker et al. (1976) studied this question.
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