open access

Vol 48, No 4 (2016)
Original and clinical articles
Submitted: 2016-10-28
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Anaesthesia for carotid endarterectomy. Ultrasound-guided superficial/intermediate cervical plexus block combined with carotid sheath infiltration

Paweł Mądro, Alina Dąbrowska, Jarosław Jarecki, Piotr Garba
DOI: 10.5603/AIT.2016.0043
·
Anaesthesiol Intensive Ther 2016;48(4):234-238.

open access

Vol 48, No 4 (2016)
Original and clinical articles
Submitted: 2016-10-28

Abstract

BACKGROUND: Carotid endarterectomy carries a significant risk of intraoperative brain ischaemia. Various methods for intraoperative cerebral function monitoring can be utilized, but the assessment of the patient’s consciousness remains the easiest and most available method, requiring that the patient remain awake and under local/regional anaesthesia. The aim of this study was to compare infiltration anaesthesia with an ultrasound–guided superficial/combined cervical plexus block for patient safety and comfort.

METHODS: Ninety-eight patients scheduled for carotid endarterectomy were randomly assigned to receive either infiltration anaesthesia performed by the surgeon or an US-guided superficial/combined cervical plexus block. The pain intensity using the numerical rating scale (NRS), the volume of local anaesthetic used and the anaesthesia-related complications were recorded. The data were analysed using selected statistical tools.

RESULTS: In the US-guided group, a significantly lower volume of local anaesthetic was used (25 mL vs. 30 mL), and lower mean (1 vs. 3) and maximal (2 vs. 6) NRS scores were observed. However, hoarseness, cough and difficulty swallowing were significantly more frequent among those patients (90% vs. 27%, 30% vs. 12%, and 36% vs. 6%, respectively).

CONCLUSIONS: Compared with infiltration anaesthesia, an US-guided superficial/combined cervical plexus block is an effective method for improving the comfort of the patient and the surgeon. The technique is safe, relatively simple and easy to master and requires little time to perform.

Abstract

BACKGROUND: Carotid endarterectomy carries a significant risk of intraoperative brain ischaemia. Various methods for intraoperative cerebral function monitoring can be utilized, but the assessment of the patient’s consciousness remains the easiest and most available method, requiring that the patient remain awake and under local/regional anaesthesia. The aim of this study was to compare infiltration anaesthesia with an ultrasound–guided superficial/combined cervical plexus block for patient safety and comfort.

METHODS: Ninety-eight patients scheduled for carotid endarterectomy were randomly assigned to receive either infiltration anaesthesia performed by the surgeon or an US-guided superficial/combined cervical plexus block. The pain intensity using the numerical rating scale (NRS), the volume of local anaesthetic used and the anaesthesia-related complications were recorded. The data were analysed using selected statistical tools.

RESULTS: In the US-guided group, a significantly lower volume of local anaesthetic was used (25 mL vs. 30 mL), and lower mean (1 vs. 3) and maximal (2 vs. 6) NRS scores were observed. However, hoarseness, cough and difficulty swallowing were significantly more frequent among those patients (90% vs. 27%, 30% vs. 12%, and 36% vs. 6%, respectively).

CONCLUSIONS: Compared with infiltration anaesthesia, an US-guided superficial/combined cervical plexus block is an effective method for improving the comfort of the patient and the surgeon. The technique is safe, relatively simple and easy to master and requires little time to perform.

Get Citation

Keywords

carotid endarterectomy, anaesthesia; cervical plexus, block; ultrasound

About this article
Title

Anaesthesia for carotid endarterectomy. Ultrasound-guided superficial/intermediate cervical plexus block combined with carotid sheath infiltration

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 48, No 4 (2016)

Pages

234-238

DOI

10.5603/AIT.2016.0043

Bibliographic record

Anaesthesiol Intensive Ther 2016;48(4):234-238.

Keywords

carotid endarterectomy
anaesthesia
cervical plexus
block
ultrasound

Authors

Paweł Mądro
Alina Dąbrowska
Jarosław Jarecki
Piotr Garba

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