title: Effect of carotid sinus nerve blockade on hemodynamic stability during carotid endarterectomy under local anesthesia.
abstract: OBJECTIVE
  To find out whether routine carotid sinus nerve blockade with lidocaine during carotid endarterectomy under local anesthesia results in perioperative changes in blood pressure and heart rate.
  
  
  METHODS
  This was a prospective, randomized, single-center study, conducted in a university hospital. A total of 120 patients undergoing carotid endarterectomy under local anesthesia were randomly assigned to three equal groups. Patients with previous carotid endarterectomy were excluded from the study. During the operation the carotid sinus area was infiltrated as follows: group 1 received 2 mL of 1% lidocaine; group 2 received 2 mL of 0.9% NaCl; and group 3 received no infiltration. The carotid sinus nerve was spared in all patients. Blood pressure and heart rate were invasively monitored during the operation and 12 hours postoperatively over the radial artery cannula. Preoperative values were calculated as a mean of three noninvasive measurements on the day before surgery. Data comprised of arterial blood pressures and heart rates from 32 time point measurements for each patient were analyzed.
  
  
  RESULTS
  There was no significant difference among the groups regarding the mean arterial blood pressures and mean heart rates during the follow-up period. There was no significant difference among groups regarding the number of patients that required vasoactive therapy at any time of measurement.
  
  
  CONCLUSIONS
  Routine infiltration of carotid sinus area with 1% lidocaine during carotid endarterectomy performed under local anesthesia has no significant impact on mean arterial blood pressure and heart rate during the operative procedure and the following 12 postoperative hours.
authors.affiliation: Department of Vascular Surgery, University Hospital Dubrava, Zagreb, Croatia. majduk@yahoo.com
authors.forename: Marko
authors.initials: M
authors.lastname: Ajduk
authors.forename: Ivana
authors.initials: I
authors.lastname: Tudorić
authors.forename: Mirko
authors.initials: M
authors.lastname: Sarlija
authors.forename: Predrag
authors.initials: P
authors.lastname: Pavić
authors.forename: Zrinka
authors.initials: Z
authors.lastname: Oremuš
authors.forename: Rebeka
authors.initials: R
authors.lastname: Held
authors.forename: Leonardo
authors.initials: L
authors.lastname: Patrlj
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000009:adverse effects; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects; D002346:Carotid Sinus / Q000294:innervation*; D016893:Carotid Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016009:Chi-Square Distribution; D016894:Endarterectomy, Carotid / Q000009:adverse effects; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006785:Hospitals, University; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009407:Nerve Block / Q000009:adverse effects; D011446:Prospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine