Intraoperative lidocaine injection into the carotid sinus during endarterectomy.
OBJECTIVE
Many surgeons inject a local anesthetic agent into the carotid sinus before carotid endarterectomy in an attempt to ameliorate perioperative hemodynamic instability. The purpose of this study is to analyze the effect of carotid sinus injection with lidocaine on perioperative hemodynamics and complications.


METHODS
The authors prospectively studied 92 patients in whom 100 consecutive carotid endarterectomies were performed by a single surgeon (eight procedures were bilateral). Patients were randomly assigned to one of two groups, in which either 0.5 ml of 1% lidocaine was injected into the carotid sinus nerve or no injection of lidocaine was administered before the arteriotomy. All patients were treated postoperatively according to a standard endarterectomy protocol. There were no significant differences between the two groups in the incidence of hypertension, hypotension, or the use of vasoactive medications in the operating room following restoration of carotid artery (CA) blood flow, in the recovery room, or in the intensive care unit.


CONCLUSIONS
Injection of lidocaine into the carotid sinus at the time of endarterectomy is not associated with a significant improvement in any hemodynamic factor, from the time of restoration of CA blood flow to postoperative Day 1.
Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
Cormac O
CO
Maher
Nicholas M
NM
Wetjen
Jonathan A
JA
Friedman
Fredric B
FB
Meyer
D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002346:Carotid Sinus / Q000187:drug effects*; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D006973:Hypertension / Q000517:prevention & control; D007022:Hypotension / Q000517:prevention & control; D007430:Intraoperative Care; D007431:Intraoperative Complications / Q000517:prevention & control; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
D000779:Anesthetics, Local; D008012:Lidocaine