AI Article Synopsis
- The review focused on gathering the latest information about anesthesia and other medical practices for a surgery called carotid endarterectomy.
- They examined many studies from specific medical databases to find the best practices and results.
- The findings suggested that using any anesthesia and checking brain function during surgery can help patients do better, but there wasn't enough proof on whether to reverse a medicine called heparin after surgery. They also mentioned keeping an eye on blood pressure after surgery, even though the evidence was weak.
Article 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.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10245611 | PMC |
| http://dx.doi.org/10.1186/s44158-022-00052-9 | DOI Listing |
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