49 -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

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.

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

Pages: 261–267

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 261-267 https://newdayworldmedicine3d.com/en/new_day_medicine/10-84-2025

List of References

  1. Basha M.A.A., Alnaggar A.A., Refaat R., El-Maghraby A.M., ., et al. The validity and reproducibility of the thyroid imaging reporting and data system (TI-RADS) in categorization of thyroid nodules: Multicentre prospective study. //Eur. J. Radiol. 2019;117:184–192. doi: 10.1016/j.ejrad.2019.06.015
  2. Gharib H., Papini E., Paschke R. Thyroid nodules: A review of current guidelines, practices, and prospects. // Eur. J. Endocrinol. 2008;159:493–505. doi: 10.1530/EJE-08-0135.
  3. Gharib H., Papini E., Paschke R., Duick D.S., Valcavi R., Hegedüs L., Vitti P., Tseleni-Balafouta S., Baloch Z., Crescenzi A., et al. American Association of ClinicalEndocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules: Executive Summary of Recommendations. // Endocr. Pr. 2010;16:468–475. doi: 10.4158/EP.16.3.468.
  4. Paschou S.A., Vryonidou A., Goulis D.G. Thyroid nodules: A guide to assessment, treatment and follow-up. // Maturitas. 2017;96:1–9. doi: 10.1016/j.maturitas.2016.11.002.
  5. Lee M.-J., Kim E.-K., Kwak J.Y., Kim M.J. Partially Cystic Thyroid Nodules on Ultrasound: Probability of Malignancy and Sonographic Differentiation. // Thyroid. 2009;19:341–346. doi: 10.1089/thy.2008.0250
  6. Baş H., Üstüner E., Kula S., Konca C., Demirer S., Elhan A.H. Elastography and Doppler May Bring a New Perspective to TIRADS, Altering Conventional Ultrasonography Dominance. //Acad. Radiol. 2021;13:1076. doi: 10.1016/j.acra.2021.02.011.
  7. Horvath E., Majlis S., Rossi R., Franco C., Niedmann J.P., Castro A., Dominguez M. An Ultrasonogram Reporting System for Thyroid Nodules Stratifying Cancer Risk for Clinical Management. //J. Clin. Endocrinol. Metab. 2009;94:1748–1751. doi: 10.1210/jc.2008-1724
  8. Zhao R, Wang X, Zou L, Zhang W. Outcomes of myomectomy during caesarean section in pregnant women with uterine fibroids: a retrospective cohort study. // Biomed Res Int. 2019; 2019 : 7576934. Epb 2019/04/09. doi: 10.1155/2019/7576934 ;
  9. Milazzo G.N., Catalano A., Badia V., Mallozzi M., Caserta D. Fibroids and myomectomy: poor evidence for pregnancy anxiety. // J Obstet Gynaecol Res. 2017; 43(12): 1789–804. Epb 2017/09/12. doi: 10.1111/jog.13437.
  10. Strobelt N, Ghidini A, Cavallone M, Pensabene I, Ceruti P, Vergani P. Natural history of uterine leiomyoma during pregnancy. // J Ultrasound Med. 1994; 13(5): 399–401. Epb 1994/05/01. doi: 10.7863/June 1994.13.5.399.
  11. Awiwi MO, Badawy M, Shaaban AM, Menias CO, Horowitz JM, Soliman M, Jensen CT, Gaballah AH, Ibarra-Rovira JJ, Feldman MK, Wang MX, Liu PS, Elsayes KM. Review of uterine fibroids: imaging of typical and atypical features, variants, and mimics with emphasis on workup and FIGO classification. // Abdom Radiol(NY). 2022 Jul;47(7):2468-2485. doi: 10.1007/s00261-022-03545-x.
Download Full Text (PDF)