EARLY EXTUBATION AND NEUROLOGIC EXAMINATION FOLLOWING COMBINED CAROTID ENDARTERECTOMY AND CORONARY-ARTERY BYPASS-GRAFTING USING REMIFENTANIL

Carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG ) as a combined procedure is occurring with increasing frequency. CEA- CABG incurs the morbidity of both procedures, and considerations for t his procedure include anesthetic techniques that provide hemodynamic s tability and prompt emergence from anesthesia. We present, to our know ledge, the first reported use in a combined CEA-CABG of the novel opio id remifentanil as a component of the anesthetic technique to achieve these goals. Remifentanil allows for early neurologic evaluation witho ut sacrificing the hemodynamic stability of traditional, high-dose opi oid techniques. (C) 1998 by Elsevier Science Inc.