Anesthesia for carotid paraganglioma exeresis. Report of 3 cases
Granell, M.; Tommasi, M.; Ubeda, J.; Chaves, S.; Soriano, J.L.; Todolí, J.; Grau, F.
Revista Espanola de Anestesiologia y Reanimacion 48(8): 387-392
2001
ISSN/ISBN: 0034-9356 PMID: 11674986 Document Number: 529496
This report of carotid paraganglioma excision in three patients discusses differential diagnosis, preoperative assessment, preoperative embolization of the tumor, monitoring of anesthesia including cerebral oximetry, and postoperative complications. We consider cerebral protection to be essential during carotid paraganglioma surgery. Such protection may be provided by drugs such as sodium thiopental and by temporarily shunting the internal carotid artery. Preoperative angiography is also important for evaluating retrograde circulation through Willis's polygon and to examine the arteries irrigating the tumor. Information thus obtained helps establish the need for presurgical embolization of the tumor, thereby possibly reducing the risks, such as obstructive hematoma that are inherent to the procedure. Finally, in our opinion, full monitoring should include cerebral oximetry so that possible complications can be detected and resolved.