Comparison of Combined (Deep and Superficial) and Intermediate Cervical Plexus Block by Use of Ultrasound Guidance for Carotid Endarterectomy

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• 作者：Ali Sait Kavaklı ; MD^* ; ^{alisaitkavakli@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Nilg&uuml ; n Kavrut Ö ; zt&uuml ; rk ; MD^* ; Raif Umut Ayoğlu ; MD^&dagger ; ; Kadir Sağdıç ; MD^&dagger ; ; G&uuml ; l Ç ; akmak ; MD^* ; Kerem İnanoğlu ; MD^* ; Mustafa Emmiler ; MD^&dagger ;
• 关键词：regional anesthesia ; cervical plexus block ; carotid endarterectomy ; ultrasound guidance
• 刊名：Journal of Cardiothoracic and Vascular Anesthesia
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：30
• 期：2
• 页码：317-322
• 全文大小：348 K

文摘

Carotid endarterectomy under regional anesthesia may be performed by using superficial, intermediate, deep or combined cervical plexus block. The authors compared the combined and intermediate cervical plexus block by use of ultrasound guidance in patients undergoing carotid endarterectomy.

bsSec_2">Design

A prospective, randomized, double-blinded trial.

bsSec_3">Setting

Education and research hospital.

bsSec_4">Participants

Adult patients undergoing carotid artery surgery.

bsSec_5">Interventions

Forty-eight patients were randomized to receive either combined cervical plexus block (deep plus superficial) or intermediate cervical plexus block by use of ultrasound guidance for carotid endarterectomy. The primary outcome measure was the amount of supplemental 1% lidocaine used by the surgeon. Secondary outcome measures were the time for the first analgesic requirement after surgery, block-related complications, postoperative visual analog scale score, and patient and surgeon satisfaction.

bsSec_6">Measurements and Main Results

Intraoperative supplemental lidocaine requirements were 3.0±1.9 mL in the combined-block group and 7.8±3.8 mL in the intermediate block group. These differences were statistically significant. There were no significant differences between the 2 groups in block-related complications and the time between the block completion and the first administration of the first dose of intravenous analgesic. In the combined-block group, maximum visual analog scale score was lower at 3 hours (2.2 [1-5] v 5.3 [3-8]), and patient satisfaction score was higher than the intermediate-block group (4.3 [3-5] v 3.1 [1-4]). One regional anesthesia procedure was converted to general anesthesia in the combined-block group.

bsSec_7">Conclusions

Ultrasound-guided combined cervical plexus block compared to intermediate cervical plexus block led to less additional analgesic use, lower visual analog scale score, and higher patient satisfaction.