Table 1

Anaesthesia protocols

General anaesthesia
Local anaesthesia

Premedication: benzodiazepine or none
Premedication: benzodiazepine or none
Intravenous access + arterial line under local anaesthetic
Intravenous access + arterial line under local anaesthetic
Intravenous induction + opiate analgesia
Judicious conscious sedation (e.g. benzodiazepine/opiate)
Muscle relaxant
Deep and superficial cervical plexus block + local infiltration (e.g. with bupivacaine)
Tracheal intubation, ventilation to normocapnia
Intra-operative top-up of local anaesthetic if required (lignocaine)
Maintain systemic blood pressure to pre-operative levels with intravenous fluids/cardioactive drugs if required
Maintain systemic blood pressures to pre-operative levels with intravenous fluids/cardioactive drugs if required
Reversal of anaesthetic and extubation
O2 as necessary by nasal cannulae/mask, in particular during cross-clamping of carotid vessels
Oxygen overnight by nasal cannulae/mask


Each trial centre will continue with their standard anaesthesia protocol. Strict guidelines on anaesthetic management are unnecessary given that each surgical procedure is a 'package' of anaesthetic and surgical care. In general terms the anaesthesia protocols in this table should be used.

Gough et al. Trials 2008 9:28   doi:10.1186/1745-6215-9-28