[Carotid endarterectomy using cervical plexus block].
To evaluate the efficacy and level of patient satisfaction, as well as the incidence of neurological manifestations, hemodynamic changes and other perioperative complications of cervical plexus block. This was a prospective study of 52 patients undergoing carotid endarterectomy under superficial and deep cervical plexus block. The anesthetic technique was effective in all cases. Supplementation with local anesthetic was needed for 25% of the patients and none required general anesthesia. The technique was considered good by 92% of the patients, who stated that would accept the same technique in case of having to undergo surgery on the contralateral carotid artery. Hypertension was the hemodynamic change observed most often (in 30%) during surgery. No serious complications related to the anesthetic technique were observed, though transient dysphonia was the most frequently seen effect (in 36.5%). Eight (15.4%) patients showed neurological signs when the carotid was clamped, with symptoms resolving with placement of a shunt. Two deaths due to myocardial infarction occurred after surgery and 1 patient suffered a permanent cerebrovascular accident. Regional anesthesia with deep and superficial cervical plexus block during carotid endarterectomy allows for continuous evaluation of the patient's neurological status and facilitates the selective use of intraluminal shunt for the prevention of stroke accident during surgery. The technique is well-tolerated by patients, does not make surgery more difficult, does not give rise to serious complications and the incidence of local complications is low.
Aguilar
C
C
Servicio de Anestesiología, Hospital Universitario San Carlos, Madrid.
Malillos
S
S
Aroca
M
M
Serrano
J
J
López-Timoneda
F
F
D000368:Aged; D001340:Autonomic Nerve Block / Q000009:adverse effects; D002561:Cerebrovascular Disorders / Q000209:etiology; D002572:Cervical Plexus; D016894:Endarterectomy, Carotid / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D010342:Patient Acceptance of Health Care; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies
Endarterectomía carotídea mediante bloqueo del plexo cervical.