title: Is carotid endarterectomy under the cervical plexus block safe for all patients with various degree of cardiovascular risk?
abstract: BACKGROUND
  The result of the GALA study did not answer the question whether it is safe to perform carotid endarterectomy (CEA) under the cervical plexus block (CPB) in patients at high cardiovascular (CV) risk. The aim of the study was to compare CV stability and the frequency of cardiovascular and neurological complications in 3 groups of patients with various degree of CV risk who underwent CEA under CPB.
  
  
  METHODS
  60 patients operated on in CPB were divided into the 3 groups according to the degree of their CV risk (I: very high, II: medium, III: low).
  
  
  METHODS
  Chi-square, Kruskal Wallis test.
  
  
  RESULTS
  No statistically significant difference was confirmed in the changes of blood pressure (MAP, BP syst, BP diast), heart rate, cardiovascular complications, the rate of the shunt insertion and neurological complications and the level of haemodynamic instability, except for hypotension (p = 0.041) in the three groups. Life threatening CV complications did not occur in any of the groups. The frequency of haemodynamic changes and postoperative complications: hypertension (I--40%, II--60%, III--60%), hypotension (I--35%, II--25%, III--5%), arrhythmias (I--30%, II--15%, III--10%), neurological complications: 2x (TIA), the frequency of shunt insertion: 15 %.
  
  
  CONCLUSIONS
  CPB can be performed in all three groups of patients, even in high-risk cardiac patients. The results will have to be confirmed in a larger group of patients in future (Tab. 3, Fig. 4, Ref. 16).
authors.affiliation: Department of Anaesthesia and Intensive Care, Masaryk University, Faculty Hospital Brno, Czech Republic. j.mann@seznam.cz
authors.forename: J H
authors.initials: JH
authors.lastname: Mannova
authors.forename: Z
authors.initials: Z
authors.lastname: Silhart
authors.forename: A
authors.initials: A
authors.lastname: Prokes
authors.forename: J
authors.initials: J
authors.lastname: Cupera
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology*; D002572:Cervical Plexus; D016894:Endarterectomy, Carotid; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D011183:Postoperative Complications