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British Journal of Anaesthesia 2005 95(2):274-275; doi:10.1093/bja/aei572
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journal.permissions@oupjournals.org

CORRESPONDENCE

Oxygen administration can reverse neurological deficit following carotid cross-clamping

* E-mail: chrisimray@aol.com

The first 10% of the full text of this article appears below.

Editor—We read with interest Stoneham and Martin's recent case report1 describing two patients who became neurologically obtunded during awake carotid surgery. They found that administration of oxygen 100% through a tight-fitting anaesthetic face mask and circle-breathing system reversed the neurological deficits, so that surgery could be completed without the need for shunting.

Two common mechanisms cause neurological deficits during carotid surgery: cerebral hypoperfusion, which is usually reversible; and macro-embolization, which is often irreversible. Most patients, undergoing loco-regional carotid surgery, will tolerate the cross-clamp phase without difficulty, however, in those patients who do become obtunded, a clear strategy needs to be agreed in advance by both anaesthetist and surgeon. We handle deficits that occur within the first 90 s by declamping the artery and allowing the deficit to recover. The operation is then continued under general anaesthesia and the carotid shunt can be inserted in . . . [Full Text of this Article]

C. H. E. Imray*, A. J. Thacker and M. K. Mead

Coventry, UK

E-mail: richardfg@hotmail.com

R. G. Fiddian-Green

E-mail: mark.stoneham@nda.ox.ac.uk

M. D. Stoneham

Oxford


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This article has been cited by other articles:


Home page
 Br J AnaesthHome page
A. S. Baraka, M. Nawfal, M. El-Khatib, and S. Haroun-Bizri
Regional cerebral oximetry after oxygen administration
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[Full Text] [PDF]

E-letters:

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On reducing the metabolic need for cerebral blood flow in carotid surgery.
Richard G Fiddian-Green
British Journal of Anaesthesia, 8 Aug 2006 [Full text]
Re: On reducing the metabolic need for cerebral blood flow in carotid surgery.
Christopher H E Imray
British Journal of Anaesthesia, 22 Aug 2006 [Full text]
Manipulating rCOD and rCOC : a false clinical meme complex?
Richard G Fiddian-Green
British Journal of Anaesthesia, 11 Sep 2006 [Full text]
Chronic cerebral ischaemia: the primary cause of neuropsychiatric complications from carotid surgery
Richard G Fiddian-Green
British Journal of Anaesthesia, 11 Sep 2006 [Full text]
Baroreceptor dysfunction during carotid artery surgery
Richard G Fiddian-Green
British Journal of Anaesthesia, 27 Sep 2006 [Full text]
Substrate depletion in locoregional carotid surgery?
Chritopher H E Imray, et al.
British Journal of Anaesthesia, 27 Sep 2006 [Full text]