RESUMO
The safe and effective perioperative management of the patient with a cardiac rhythm management device (ie, pacemaker and/or implantable cardioverter defibrillator) is based entirely on the avoidance of adverse outcomes, including damage to the device, the leads, or the site of lead implantation that might prevent the device from functioning as intended. An important management principle is the potential reprogramming of such a device in the perioperative period to avoid transient interruption of device function or the delivery of inappropriate electrophysiological therapy (eg, unnecessary defibrillation or pacing). Given the large numbers of patients worldwide currently implanted with these devices, the anesthesia practitioner should become electively familiar with the current technology. This article describes the current status of cardiac rhythm management devices and discusses recommended perioperative management.
Assuntos
Desfibriladores Implantáveis , Marca-Passo Artificial , Assistência Perioperatória/métodos , Anestesia , Campos Eletromagnéticos , Humanos , Cuidados Intraoperatórios , Cuidados Pós-Operatórios , Terminologia como AssuntoRESUMO
First reports on surgical treatment of cerebrovascular atherosclerosis date to the early 1950s. With advancements in surgical technique, carotid endarterectomy (CEA) has become the treatment of choice for patients with both symptomatic and asymptomatic severe carotid stenosis. Given the benefits that surgery offers beyond medical management, the number of CEA procedures continues to increase. The intraoperative management of patients undergoing CEA is challenging because of the combination of patient and surgical factors. This article explores and reviews the literature on anesthetic management and considerations of patients undergoing CEA.