[Anesthesia for combined carotid endarterectomy and coronary artery bypass grafting].

The anesthesia for combined carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) is mentioned in this report. Although electroencephalogram was set up to detect the sign of brain ischemia during surgery, it became unreliable because of electrical noise from the medical instruments. Another monitoring method, such as trans-cranial Doppler, was thought to be needed to avoid the electrical noise. In anesthesia, a gradual measured induction with judicious fluid loading was imperative along with a protection from the reflex response to pain stimuli. Thiopental was used to protect the brain from ischemic injury during CEA. The perfusion pressure during cardiopulmonary bypass was maintained at 55-65 mmHg, and no neurological complication was seen.