Abstract: Background Carotid endarterectomy(CEA) is one of the major choices for the treatment of carotid stenosis. A variety of intraoperative monitoring and management techniques were used to respectively detect and reverse cerebral ischemia. However, the incidences of perioperative complications and stroke are still as high as 5%. Appropriate anesthetic management might be of great importance to lower the incidences. Objective To review studies in anesthetic monitoring and management during CEA. Content CEA has been used to eliminate plaques deposited on the wall of carotid. To perform this surgery, both upstream and downstream parts of carotid around the plaques have to be clamped, which produces transient cerebral ischemia, usually followed by complications. To prevent the complications, perioperative monitoring techniques have been performed to fulfill real-time measurement of hemodynamic and neurophysiological parameters. The techniques include cerebral regional oxygen saturation, stump pressure, transcranial doppler, even-related potentials, jugular bulb venous oxygen saturation, and consciousness during awake, etc. This paper reviews the principles and advancements of these techniques and also their application in CEA. Trend During CEA, combinatory monitoring of multiple parameters may be necessary to obtain synthetic feedback information to improve safety and prognosis of the patients.
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