[Cervical plexus block and continuous cervical peridural block with ropivacaine for carotid surgery: a comparison between the 2 methods].
OBJECTIVE
To evaluate the efficacy and security of the cervical plexus block and the continuous cervical peridural anaesthesia in carotid surgery, using ropivacaine as local anaesthetic.


METHODS
90 patients (ASA II-III, age 67-84) who had signed informed consent were randomised in two groups. In Group C continuous cervical plexus block was performed using ropivacaine 0,75% 2,5 mg/kg. In Group P continuous cervical peridural anaesthesia was performed, at level C6-C7 or C7-T1, introducing the catheter for 5 cm into the epidural space and injecting in 20 min ropicavacine 0,5% 0,9 mg/kg together with 50-100 g of fentanyl. ECG, HR, arterial blood pressure, neurological status of conscious patient and eventual complications were all monitored.


RESULTS
Demographical data, duration of surgery and level of anaesthesia were all uniform in both groups. At the onset of the block the values of the systolic arterial blood pressure were significantly lower in Group P compared to Group C. One case of intradural injection of ropivacaine was reported and one case of intravascular injection, without remaining deficits. There were no perioperative complications.


CONCLUSIONS
cervical plexus block and continuous cervical peridural anaesthesia performed with ropivacaine are both effective for anaesthesia in carotid surgery. Ropivacaine, for its minor cardiotoxicity, yields eventual complications related to the two methods, less severe.
Seraglio
P
P
Servizio di Anestesia, Rianimazione e Terapia Antalgica, ASL n. 4 Alto Vicentino, Ospedale S. Camillo de Lellis, Schio (VI), Italy.
Campostella
F A
FA
D000368:Aged; D000369:Aged, 80 and over; D000577:Amides; D000767:Anesthesia, Epidural; D000779:Anesthetics, Local; D016893:Carotid Stenosis / Q000601:surgery*; D002572:Cervical Plexus; D005260:Female; D006801:Humans; D008297:Male; D009407:Nerve Block / Q000379:methods*; D000077212:Ropivacaine
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine
Blocco del plesso cervicale e blocco peridurale cervicale continuo con ropivacaina per la chirurgia carotidea: confronto fra le due metodiche.