Variation of cerebral blood flow velocity during carotid endarterectomy
Xing Qi
Ouyang Chuan
Luo Xingliao
He Chen
Abstract：Objective To investigate blood flow velocity variation in middle cerebral artery(MCA) during carotid endarterectomy(CEA) by transcranial Doppler (TCD).Methods Totally 67 patients who had CEA for unilateral carotid artery stenosis(affected side stenosis ＞70％,opposite side stenosis ＜ 30％) were retrospectively analyzed.All patients had combined intravenous-inhalational general anesthesia with midazolam,rocuronium,sufentanil and propofol.Peak blood flow velocities (Vp) and mean blood flow velocities (Vm) in bilateral MCA were monitered by TCD at the time of entering operation room(T0),between anesthesia induction and intubation (T1),separating carotid artery(T2),5 min after blocking carotid artery (T3),5 min after placing bypass tube in carotid artery(T4),5 min after recovering carotid artery blood flow (T5)and 1 h after recovering carotid artery blood flow(T6).Pearson correlation test was used to analyze the correlation of cerebral blood flow velocity between operating side and opposite side.Results In operating side,Vp at T2 time point was significantly lower than that in opposite side[(70 ± 23)cn/s vs (93 ±32)cm/s,P ＜ 0.05];Vp and Vm at T3 were significantly lower than those in opposite side[(65 ±26)cm/s vs (106± 49)cm/s,(40 ± 16)cm/s vs (54 ± 24)cm/s,P ＜ 0.01].In operating side,Vp and Vm at T1 were significantly lower than those at T0 [(78 ± 31)cm/s vs (98 ± 27)cm/s,(50 ±26)cm/s vs (61 ± 18)cm/s,P ＜0.01 or P ＜0.05].During the operation(T1-T6),Vp and Vm in operating side decreased to minimum at T3,while these indexes increased to maximum in opposite side at T3.At T6,Vpin operating side was significantly higher than that at T2 and T3 [(70 ± 23),(65 ± 26) cm/s vs (92 ± 23) cm/s,P ＜ 0.05].Pearson correlation test showed positive correlation of cerebral blood flow velocity between operating side and opposite side at T6 (r2 =0.542 and 0.649,P ＜ 0.05).Conclusion General anesthesia can cause significant reduction of cerebral blood flow velocity during CEA;in non-operating side,there is a compensatory elevation after blocking carotid artery,which disappears after placing carotid bypass tube;1 h after recovering carotid artery blood flow,cerebral blood flow velocity in operating side restores to basic level;bilateral cerebral blood flow velocities show synchronous variation trend.
Keywords：Carotid endarterectomyCerebral blood flow velocityGeneral anesthesia
Publication Date：2016-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1303-1307 )