Anesthetic management of carotid endarterectomy: an update from Italian guidelines
Abstract Background and aims In order to systematically review the latest evidence on anesthesia, intraoperative neurologic monitoring, postoperative heparin reversal, and postoperative blood pressure management for carotid endarterectomy. The present review is based on a single chapter of the Italian Health Institute Guidelines for diagnosis and treatment of extracranial carotid stenosis and stroke prevention. Methods and results A systematic article review focused on the previously cited topics published between January 2016 and October 2020 has been performed; we looked for both primary and secondary studies in the extensive archive of Medline/PubMed and Cochrane library databases. We selected 14 systematic reviews and meta-analyses, 13 randomized controlled trials, 8 observational studies, and 1 narrative review. Based on this analysis, syntheses of the available evidence were shared and recommendations were indicated complying with the GRADE-SIGN version methodology. Conclusions From this up-to-date analysis, it has emerged that any type of anesthesia and neurological monitoring method is related to a better outcome after carotid endarterectomy. In addition, insufficient evidence was found to justify reversal or no-reversal of heparin at the end of surgery. Furthermore, despite a low evidence level, a suggestion for blood pressure monitoring in the postoperative period was formulated..
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:2 |
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| Enthalten in: |
Journal of Anesthesia, Analgesia and Critical Care - 2(2022), 1, Seite 12 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Sergio Bevilacqua [VerfasserIn] |
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| Links: |
doi.org [kostenfrei] |
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| doi: |
10.1186/s44158-022-00052-9 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
DOAJ027877914 |
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| 520 | |a Abstract Background and aims In order to systematically review the latest evidence on anesthesia, intraoperative neurologic monitoring, postoperative heparin reversal, and postoperative blood pressure management for carotid endarterectomy. The present review is based on a single chapter of the Italian Health Institute Guidelines for diagnosis and treatment of extracranial carotid stenosis and stroke prevention. Methods and results A systematic article review focused on the previously cited topics published between January 2016 and October 2020 has been performed; we looked for both primary and secondary studies in the extensive archive of Medline/PubMed and Cochrane library databases. We selected 14 systematic reviews and meta-analyses, 13 randomized controlled trials, 8 observational studies, and 1 narrative review. Based on this analysis, syntheses of the available evidence were shared and recommendations were indicated complying with the GRADE-SIGN version methodology. Conclusions From this up-to-date analysis, it has emerged that any type of anesthesia and neurological monitoring method is related to a better outcome after carotid endarterectomy. In addition, insufficient evidence was found to justify reversal or no-reversal of heparin at the end of surgery. Furthermore, despite a low evidence level, a suggestion for blood pressure monitoring in the postoperative period was formulated. | ||
| 650 | 4 | |a Carotid endarterectomy | |
| 650 | 4 | |a Anesthesia | |
| 650 | 4 | |a Intraoperative cerebral monitoring | |
| 650 | 4 | |a Heparin reversal | |
| 650 | 4 | |a Blood pressure monitoring | |
| 650 | 4 | |a Guidelines | |
| 653 | 0 | |a Anesthesiology | |
| 653 | 0 | |a Medical emergencies. Critical care. Intensive care. First aid | |
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| 700 | 0 | |a Giuseppe Alba |e verfasserin |4 aut | |
| 700 | 0 | |a Laura Capoccia |e verfasserin |4 aut | |
| 700 | 0 | |a Alessandro Cappelli |e verfasserin |4 aut | |
| 700 | 0 | |a Carlo Cernetti |e verfasserin |4 aut | |
| 700 | 0 | |a Marina Diomedi |e verfasserin |4 aut | |
| 700 | 0 | |a Walter Dorigo |e verfasserin |4 aut | |
| 700 | 0 | |a Gianluca Faggioli |e verfasserin |4 aut | |
| 700 | 0 | |a Giovanni Giannace |e verfasserin |4 aut | |
| 700 | 0 | |a David Giannandrea |e verfasserin |4 aut | |
| 700 | 0 | |a Matteo Giannetta |e verfasserin |4 aut | |
| 700 | 0 | |a Gianfranco Lessiani |e verfasserin |4 aut | |
| 700 | 0 | |a Enrico Maria Marone |e verfasserin |4 aut | |
| 700 | 0 | |a Daniela Mazzaccaro |e verfasserin |4 aut | |
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| 700 | 0 | |a Gabriele Pagliariccio |e verfasserin |4 aut | |
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| 700 | 0 | |a Jessica Lanza |e verfasserin |4 aut | |
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