Nursing Pharmacology:  Clinical Case

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Clinical Case

  • A 78 year-old woman suffered from transient ischemic attacks (TIAs) in which she temporarily lost consciousness.

  •  Arteriography revealed a partial obstruction of the right common carotid artery by atherosclerotic plaques.

  •  Carotid endarterectomy was scheduled.



  • Case author: Hugh S. Mathewson, M.D., Professor Emeritus, School of Allied Health, Department of Nurse Anesthesia, University of Kansas Medical Center

  • Case editor: Michael Gordon, Ph.D. Associate Professor, University of Kansas Medical Center

  1. What anesthetic procedure is indicated for this operation?
    1.   Regional anesthesia
    2.   general anesthesia, using ketamine (Ketalar) and high-dose opioids
    3.   general anesthesia, with induction using thiopental (Pentothal), succinylcholine (Anectine) for muscle paralysis, intubation and maintenance with isoflurane (Forane)/oxygen
    4.   any of the above procedures equally appropriate