carotid disease

Question 1

With carotid disease, patients are likely to be

Answer 1

systemic vasculopaths

Question 2

Preoperatve carotid neuro assessment

Answer 2

need to note baseline

residuals?
history?

Question 3

Dopper/ultrawound gives an

Answer 3

assessment of flow at stenosis

Question 4

TCAR most important anesthetic considerations

Answer 4

1. control BP (glycopyrolate)
2. prepare for airway issue (hematoma)
3. SSEPs

Question 5

Cerebral blood flow equation

Answer 5

cerebreal blood flow is cerebral perfusion pressure

CPP = MAP - ICP

Question 6

Minimal internal carotid stump pressure

Answer 6

50 mmHg or shunt needs to be plaed

looks at collateral circulation to maintain clamp

Question 7

only reliable neuro exam

Answer 7

ability to continuously monitor neurologic status of patient

awake patient

Question 8

Anesthetics that decrease CMRO2 to protect brain from ischemia

Answer 8

1. propofol
2. etomidate
3. narcotics

Question 9

traction on vessel during carotid may cause

Answer 9

stimulation of baroreceptors! (severe bradycardia and hypotension)

glyco

Question 10

Pt BP during carotid clamp

Answer 10

slightly greater than baseline (20% above pts normal)

Question 11

Emergence of postoperative care carotid

Answer 11

1. control hypertension
2. nuro assessment ASAP
3. hematoma (airway) diligence

Question 12

For increased BP, what should you rule out before treating with medication?

Answer 12

1. hypoxia
2. ETT/bucking/coughing
3. Pain
4. bladder distension

Question 13

Hematoma formation means (carotid)

Answer 13

back to the OR!

may be difficult intubation, have cart ready