An evaluation of hypocarbia and hypercarbia during carotid endarterectomy.

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Abstract
Consecutive patients [36] were randomly given hypocarbic (PaCO2 [arterial partial pressure of carbon dioxide] < 25 torr) or hypercarbic (PaCO2 > 60 torr) general anesthesia during carotid endarterectomy to test the effect of the 2 regimens upon the incidence of postoperative neurological deficit. An indwelling shunt was not used. One patient died, 2 have permanent neurological deficits and 2 have temporary neurological deficits. Although hypocarbic patients had fewer neurological complications than hypercarbic patients, the difference was not statistically significant (P < 0.13). Hypercarbia significantly increased the incidence of intraoperative arrhythmia. No relationship was found between the incidence of postoperative stroke and the internal carotid back pressure or the time of carotid occlusion.