Endarterectomia Carotídea com Anestesia Loco-Regional

 

Armando Mansilha*

* Professor Auxiliar Convidado da Faculdade de Medicina do Porto Assistente Hospitalar de Angiologia e Cirurgia Vascular no Hospital de São João Coordenador da Unidade de Angiologia e Cirurgia Vascular do Hospital CUF Porto

 

|RESUMO|

A eficácia da endarterectomia carotídea (CEA) na prevenção do acidente vascular cerebral (AVC) em doentes com estenose carotídea sintomática e assintomática foi estabelecida em vários estudos randomizados multicêntricos.

A anestesia local tem sido associada a um potencial benefício comparativamente à anestesia geral, em termos de diminuição da morbilidade neurológica e mortalidade, bem como redução de custos hospitalares.

Este artigo procura analisar e discutir os resultados publicados, particularmente a mais recente meta-análise da Cochrane e o estudo GALA, o maior estudo randomizado cirúrgico/anestésico alguma vez efectuado nesta área.

São também referidas as recomendações publicadas pela European Society for Vascular Surgery (ESVS) bem como os resultados de uma experiência pessoal.

Palavras-chave: Estenose carotídea, endarterectomia, anestesia loco-regional, anestesia geral

 

 

Carotid Endarterectomy under Local Anaesthesia

|ABSTRACT|

The efficacy of carotid endarterectomy (CEA) in preventing the stroke in patients with symptomatic and asymptomatic carotid stenosis has been established in different multicentre randomised controlled trials.

CEA under local anaesthesia versus general anaesthesia has been associated with potential benefits concerning reduction in the odds of stroke, death and hospital costs.

This review will analyse the published results, particularly those from last Cochrane meta-analysis and from GALA trial, the largest randomised surgical/anaesthetic trial ever performed in this field.

It will be also analysed the recommendations published by the European Society for Vascular Surgery (ESVS) and the singular results from a personal experience.

Key words: Carotid stenosis, endarterectomy, local anaesthesia, general anaethesia

 

Texto completo disponível apenas em PDF.

Full text only available in PDF format.

 

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