Peitzman A B, Webster M W, Loubeau J M, Grundy B L, Bahnson H T
Ann Surg. 1982 Jul;196(1):59-64. doi: 10.1097/00000658-198207000-00013.
Carotid endarterectomy is reliable in the prevention of strokes due to arteriosclerotic disease at the carotid bifurcation. This is a retrospective review of 314 carotid endarterectomies performed at the University Health Center of Pittsburgh. The objectives of the study were to determine if regional anesthesia was a safe technique for carotid endarterectomy and to determine whether the neurologic complications that occurred were embolic or ischemic in origin. In patients who were neurologically intact before operation, the perioperative mortality was 0.88% and the incidence of neurologic complications was 3.1%. This is comparable to the current literature. Observations of the awake patient suggested that half the neurologic deficits that occurred in this series were due to embolization rather than to cerebral ischemia. Further more, the incidence of non-neurologic complications under general anesthesia was 12.9%. Under regional anesthesia, the incidence of non-neurologic complications was 2.8%. The data supports carotid endarterectomy under regional block as safe and reliable method.
颈动脉内膜切除术在预防因颈动脉分叉处动脉硬化疾病导致的中风方面是可靠的。这是对匹兹堡大学健康中心进行的314例颈动脉内膜切除术的回顾性研究。该研究的目的是确定区域麻醉对于颈动脉内膜切除术是否是一种安全的技术，并确定所发生的神经并发症是栓塞性的还是缺血性的。在术前神经功能正常的患者中，围手术期死亡率为0.88%，神经并发症发生率为3.1%。这与当前文献相当。对清醒患者的观察表明，该系列中发生的神经功能缺损有一半是由于栓塞而非脑缺血。此外，全身麻醉下非神经并发症的发生率为12.9%。在区域麻醉下，非神经并发症的发生率为2.8%。数据支持区域阻滞下的颈动脉内膜切除术是一种安全可靠的方法。
