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BJA Advance Access published online on February 11, 2005
British Journal of Anaesthesia, doi:10.1093/bja/aei089
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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
Accepted December 23, 2004

Case Report

Increased oxygen administration during awake carotid surgery can reverse neurological deficit following carotid cross-clamping

M. D. Stoneham 1* and T. Martin 1

1 Nuffield Department of Anaesthetics, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK

* To whom correspondence should be addressed.
M. D. Stoneham, E-mail: mark.stoneham{at}nda.ox.ac.uk


  Abstract

We describe the management of two patients undergoing awake carotid surgery who developed signs of cerebral ischaemia following cross-clamping of the internal carotid artery. Administration of oxygen 100% with a close-fitting anaesthetic facemask reversed the neurological deficit, avoiding the need for insertion of an internal carotid artery shunt. Thus, the incidence of shunt insertion, which is reduced by the use of regional rather than general anaesthesia, could be reduced further by supplementary oxygenation. The possible mechanism and implications are discussed.

Keywords: anaesthetic techniques, regional, cervical plexus block; drugs, oxygen; surgery, carotid endarterectomy.
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E-letters:

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British Journal of Anaesthesia, 8 Aug 2005 [Full text]
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