Minerva anestesiologica
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Minerva anestesiologica · Nov 2009
Case ReportsDexmedetomidine as sole sedative during percutaneous carotid artery stenting in a patient with severe chronic obstructive pulmonary disease.
Carotid artery ballooning and stenting is a percutaneous interventional therapy for the treatment of patients with atherosclerotic occlusive disease of the carotid artery. Patients with severe comorbidities are usually considered candidates for this procedure. ⋯ This article describes the case of a patient with severe chronic obstructive pulmonary disease and severe carotid stenosis, who underwent carotid stenting under monitored anesthesia care with dexmedetomidine. Only one episode of bradycardia and hypotension was observed, and this was successfully treated with glycopyrrolate.
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Anesthesia is considered a leading discipline in the field of patient safety. Nevertheless, complications still occur and can be devastating. A substantial portion of anesthesia-related adverse events are preventable since risk factors can be detected and eliminated. ⋯ Cost cutting and production pressure in medical care are potential threats to safety. A shared knowledge of the best standards of care and of the potential consequences of unscrupulous actions could make the daily management of conflicting interests easier. A correctly applied RM can be a powerful, highly beneficial aid to our practice.