Superficial vs combined cervical plexus block for carotid endarterectomy: a prospective, randomized study.
BACKGROUND
The present study compares combined and superficial cervical plexus block in patients submitted to carotid endarterectomy (CEA) in terms of anesthetic efficacy, satisfaction of the patient and surgeon, complications resulting from the type of anesthesia, and final outcome.


METHODS
A total of 125 patients submitted to elective CEA were randomized into 2 groups: the first group was submitted to superficial cervical block and the second group to combined (superficial plus deep) cervical block.


RESULTS
No significant difference in anesthetic quality was observed between the 2 types of blocks. Complications related to the anesthetic method were observed in only 1 (1.6%) patient of the superficial block group and in 5 (7.4%) patients of the combined block group (P > .05). Anesthetic supplementation by the surgeon was necessary in 50 (81.96%) patients, with no significant difference between the 2 groups. The surgical conditions were closely similar in the 2 groups, showing no significant difference. The final morbidity and mortality in the present series was 1.6%.


CONCLUSIONS
Superficial cervical anesthetic block shows the same efficacy as combined block, with the surgical conditions being closely similar. The incidence of complications related to the anesthetic technique is higher for combined block. The type of block does not influence the final outcome of the patients.
de Sousa
Atos Alves
AA
Department of Neurosurgery, Faculdade de Ciências Médicas de Minas Gerais e Santa Casa Hospital, Belo Horizonte, MG, 30150-310 Brazil. sousatos@terra.com.br
Filho
Marcos Antônio Dellaretti
MA
Faglione
Wilson
W
Carvalho
Gervásio Telles Cardoso
GT
D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D002339:Carotid Arteries / Q000601:surgery*; D002572:Cervical Plexus / Q000187:drug effects / Q000502:physiology / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000379:methods*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000503:physiopathology; D007902:Length of Stay; D008297:Male; D019547:Neck Pain / Q000188:drug therapy / Q000517:prevention & control*; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods*; D010146:Pain / Q000188:drug therapy / Q000517:prevention & control; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011446:Prospective Studies; D016896:Treatment Outcome
D000779:Anesthetics, Local