64 -10 (84) 2025 - Ibragimov N., Nishonov M. - THE IMPACT OF SEDATION METHODS ON HEMODYNAMIC STABILITY AND SAFETY IN ELDERLY AND GERIATRIC PATIENTS UNDERGOING CAROTID ENDARTERECTOMY

THE IMPACT OF SEDATION METHODS ON HEMODYNAMIC STABILITY AND SAFETY IN ELDERLY AND GERIATRIC PATIENTS UNDERGOING CAROTID ENDARTERECTOMY

Ibragimov N. - Tashkent State Medical University

Nishonov M. - Tashkent State Medical University

Krasnenkova M. - Tashkent State Medical University

Jalilov U.A. - Anesthesiologist of the treatment ward of the Medical Center of the Central Consultative and Diagnostic Polyclinic No. 1 of the Main Department of Health.

Resume

Carotid endarterectomy (CEA) is an effective method for stroke prevention in elderly patients; however, maintaining hemodynamic stability during surgery remains a major challenge. Sedative agents used in anesthesia can significantly affect the cardiovascular system. The aim of this study was to compare the effects of different sedation methods (propofol versus ketamine combined with dexmedetomidine) on hemodynamic stability and safety in patients undergoing CEA. A prospective randomized study was conducted in 98 patients: the main group (n=49) received intramuscular ketamine with intraoperative dexmedetomidine, while the control group (n=49) received propofol sedation. The results showed that patients in the main group maintained more stable arterial blood pressure and heart rate, and experienced fewer intraoperative complications. In contrast, the propofol group demonstrated a higher incidence of arterial hypotension and bradycardia (p<0.05). These findings suggest that ketamine combined with dexmedetomidine provides better hemodynamic control and overall safety compared to propofol during CEA in elderly patients.

Keywords: Carotid endarterectomy, elderly patients, sedation, propofol, ketamine, dexmedetomidine, hemodynamic stability, intraoperative safety.

First page

352

Last page

358

For citation:Ibragimov N., Nishonov M., Krasnenkova M., Jalilov U.A. - THE IMPACT OF SEDATION METHODS ON HEMODYNAMIC STABILITY AND SAFETY IN ELDERLY AND GERIATRIC PATIENTS UNDERGOING CAROTID ENDARTERECTOMY//New Day in Medicine 10(84)2025 352-358 https://newdayworldmedicine.com/en/new_day_medicine/10-84-2025

List of References

1. Bond R, Rerkasem K., Rothwell PM. Systematic review of randomized controlled trials of carotid endarterectomy for symptomatic carotid stenosis. Stroke. 2003;34(4):1181–1186.
2. Brott TG, et al. Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med. 2010;363(1):11–23.
3. Monk TG, Price CC. Postoperative cognitive disorders. Curr Opin Crit Care. 2011;17(4):376–381.
4. Evered L, Silbert B, Knopman DS, et al. Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery—2018. Br J Anaesth. 2018;121(5):1005–1012.
5. Bilotta F, Gelb AW. Anesthesia and postoperative cognitive dysfunction in the elderly: a narrative review. Curr Opin Anaesthesiol. 2019;32(6):768–773.
6. Abdallah FW, Brull R. Facilitatory effects of perineural dexmedetomidine on neuraxial and peripheral nerve block: a systematic review and meta-analysis. Br J Anaesth. 2013;110(6):915–925.
7. Zeiler FA, Teitelbaum J, Gillman LM, West M. The ketamine effect on ICP in traumatic brain injury. Neurocrit Care. 2014;21(1):163–173.
8. Deiner S, Luo X, Lin HM, Sessler DI, et al. Intraoperative dexmedetomidine and cognitive decline after surgery in the elderly: a randomized clinical trial. Anesthesiology. 2017;126(3):486–494.
9. Д. М. Сабиров, М. Б. Красненкова Нейропротекция при травматическом повреждении головного мозга // Вестник экстренной медицины. 2009. №4. URL: https://cyberleninka.ru/article/n/neyroprotektsiya-pri-travmaticheskom-povrezhdenii-golovnogo-mozga.
10. Д. М. Сабиров, & М. Б. Красненкова (2009). Нейропротекция при травматическом повреждении головного мозга. Вестник экстренной медицины, (4), 50-54.

    file

    download