Ropivacaine 3.75 mg/ml, 5 mg/ml, or 7.5 mg/ml for cervical plexus block during carotid endarterectomy.
OBJECTIVE
To examine the effect of 225 mg (7.5 mg/mL), 150 mg (5 mg/mL), and 112.5 mg (3.75 mg/mL) ropivacaine on quality of cervical plexus block during carotid endarterectomy.


METHODS
Patients (n = 93) scheduled for carotid endarterectomy were randomized to receive a cervical plexus block with deep infiltration of 10 mL and superficial infiltration of 20-mL volumes of ropivacaine 7.5, 5.0, or 3.75 mg/mL. Pain, coughing, hemodynamic consequences of the block, postoperative visual analog scores, and pain satisfaction index were recorded. If necessary, anesthesia supplements with aliquots of 3 mL lidocaine 1% were given during surgery.


RESULTS
Incidences of coughing and hoarseness were similar in all groups. More local anesthetic infiltrations were required in the ropivacaine 3.75-mg/mL and 5-mg/mL groups. Postoperatively, no intragroup differences were observed. A trend toward better pain satisfaction was observed in the ropivacaine 7.5-mg/mL group.


CONCLUSIONS
The best quality of cervical plexus block associated with the smallest incidence of pain for patients undergoing carotid endarterectomy was obtained with 30 mL of 225 mg and 150 mg of ropivacaine, respectively.
Umbrain
Vincent J
VJ
Department of Anesthesiology (V.J.U., V.L.V.G., F.C.), Academisch Ziekenhuis, Vrije Universiteit Brussel, Laarbeeklaan, Brussels, Belgium. Vincent.Umbrain@az.vub.ac.be
van Gorp
Viola L
VL
Schmedding
Eric
E
Debing
Erik E
EE
von Kemp
Karl
K
van den Brande
Pierre M
PM
Camu
Frédéric
F
D000368:Aged; D000577:Amides / Q000009:adverse effects / Q000627:therapeutic use*; D000704:Analysis of Variance; D000779:Anesthetics, Local / Q000009:adverse effects / Q000627:therapeutic use*; D002572:Cervical Plexus / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D016894:Endarterectomy, Carotid / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009407:Nerve Block / Q000379:methods*; D010146:Pain / Q000517:prevention & control; D017060:Patient Satisfaction; D000077212:Ropivacaine; D016896:Treatment Outcome
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine