Anaesthesia for carotid endarterectomy
You are a young doctor working as anaesthetist. Your patient is scheduled for a surgical procedure known as endarterectomy because of a massive bifurcation stenosis on right sided carotid artery. From the medical history we know that our patient is a 60 years old smoker with chronic hypertension and OSA. The indication for endarterectomy is a mini stroke (TIA) experienced by the patient ten days ago, currently with no neurological deficit and diagnosed with 80 % carotid stenosis. What types of anaesthesia would you choose in your position in regard to the best outcome and the patient's medical history?
EKG
rythm: sinus
action: regular
Examination
Medical history:
Past medical history: cardiac patient on medication, OSA patient - the use of CPAP prescribed at night
Chief complain: He suffered from TIA attack 10 days ago
Family disease: no revelant
History of the present illness: He describes that he started to experience left hand tingling, later he could not move with his hand and he had difficulties to cry out at his wife for help. He fell unconscious before ambulance came, preserved breathing.
Chronic medication: Anopyrin, Betaloc, Rosucard, Agen, Trombex.
Alergies: none
