[Study of background factors of cerebral hyperperfusion syndrome in the anesthetic management of carotid endarterectomy].

BACKGROUND

We conducted a retrospective study to evaluate background factors of cerebral hyperperfusion syndrome (CHS) in the anesthetic management of carotid endarterectomy (CEA) for carotid artery stenosis.

METHODS

A total of 118 ASA 1-2 adult patients were allocated to one of two groups: Group A of 13 patients who developed CHS after CEA, and Group B of the remaining 105 patients. We weighed control percent ratio of somatosensory evoked potential (%SEP). The rate of carotid artery stenosis, stump pressure of internal carotid artery, %SEP internal carotid artery blood flow (ICF), and preoperative anesthetic problems were compared between the two groups.

RESULTS

The rate of carotid artery stenosis in Group A was 85%, significantly higher than 74% of Group B. Stump pressure in Group A was 28 mmHg, significantly lower than 37 mmHg of Group B. %SEP was 67% of Group A, and 87% of Group B, respectively ICF in Group A was 7+ +/- 33 ml min(-1), which decreaced significantly compared with 78 +/- 34 ml min(-1) of Group B.

CONCLUSIONS

We conclude that the patients with high rate of carotid artery stenosis, low stump pressure and low ICF have a high risk of developing CHS after CEA and careful attention should be required in the anesthetic management of CEA.