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.
Anesthetic management of carotid endarterectomy: an update from Italian guidelines / Bevilacqua, Sergio; Ticozzelli, Giulia; Orso, Massimiliano; Alba, Giuseppe; Capoccia, Laura; Cappelli, Alessandro; Cernetti, Carlo; Diomedi, Marina; Dorigo, Walter; Faggioli, Gianluca; Giannace, Giovanni; Giannandrea, David; Giannetta, Matteo; Lessiani, Gianfranco; Marone, Enrico Maria; Mazzaccaro, Daniela; Migliacci, Rino; Nano, Giovanni; Pagliariccio, Gabriele; Petruzzellis, Marco; Plutino, Andrea; Pomatto, Sara; Pulli, Raffaele; Sirignano, Pasqualino; Vacirca, Andrea; Visco, Emanuele; Moghadam, Shadeh Parsapour; Lanza, Gaetano; Lanza, Jessica. - In: JOURNAL OF ANESTHESIA, ANALGESIA AND CRITICAL CARE. - ISSN 2731-3786. - ELETTRONICO. - 2:1(2022), pp. 24.1-24.12. [10.1186/s44158-022-00052-9]
Anesthetic management of carotid endarterectomy: an update from Italian guidelines
Faggioli, Gianluca;Giannetta, Matteo;Pomatto, Sara;Vacirca, Andrea;
2022
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.File | Dimensione | Formato | |
---|---|---|---|
37386522 - Anesthetic management of carotid endarterectomy.pdf
accesso aperto
Tipo:
Versione (PDF) editoriale
Licenza:
Licenza per Accesso Aperto. Creative Commons Attribuzione (CCBY)
Dimensione
948.12 kB
Formato
Adobe PDF
|
948.12 kB | Adobe PDF | Visualizza/Apri |
44158_2022_52_MOESM1_ESM.docx
accesso aperto
Tipo:
File Supplementare
Licenza:
Licenza per Accesso Aperto. Creative Commons Attribuzione (CCBY)
Dimensione
19.82 kB
Formato
Microsoft Word XML
|
19.82 kB | Microsoft Word XML | Visualizza/Apri |
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.