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Canadian Journal of Anesthesia, Vol 31, 192-196, Copyright © 1984 by Canadian Anesthesiologists' Society

Myocardial Infarction Following Regional Anaesthesia for Carotid Endarterectomy

DONALD S. PROUGH MD1, PHILLIP E. SCUDERI MD1, EDWARD STULLKEN MD1, and COURTLAND H. DAVIS JR. MD1

1 Department of Anesthesia and the Section on Neurosurgery, Department of Surgery, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina

Address correspondence to: Donald S. Prough MD, Department of Anesthesia, Bowman Gray School of Medicine, 300 S. Hawthorne Road, Winston-Salem, North Carolina 27103.

From 1969 through 1982, 185 carotid endarterectomies were performed under regional anaesthesia on 153 patients. Of these patients, 38 (25 per cent) had suffered a previous myocardial infarction, 63 (41 per cent) had documented coronary artery disease, and 115 (75 per cent) had hypertension. Anaesthesia was provided by a superficial cervical plexus block. Monitoring consisted of measurement of direct arterial pressure and continuous display of the electrocardiogram. Oxygen was administered by nasal cannula throughout the procedure. Mean arterial pressure was elevated when necessary by infusion of phenylephrine. No patient in this study suffered an acute myocardial infarction. The only cardiac complications consisted of eight episodes of non-life-threatening dysrhythmias. We conclude that regional anaesthesia for carotid endarterectomy is associated with a low risk of perioperative myocardial infarction.

Key Words: SURGERY: cardiovascular, carotid endarterectomy • ANAESTHETICS, LOCAL: lidocaine, mepivacaine, prilocaine, bupivacaine • HEART: myocardial infarction






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Copyright © 1984 by the Canadian Anesthesiologists' Society.