title: Ultrasound-guided intermediate cervical block versus superficial cervical block for carotid artery endarterectomy: The randomized-controlled CERVECHO trial.
abstract: BACKGROUND
  The value of ultrasound guidance for intermediate cervical blocks in patients undergoing carotid artery endarterectomy is poorly described. This study aimed at comparing the efficacy of ultrasound-guided intermediate cervical block to superficial cervical block for carotid artery endarterectomies.
  
  
  METHODS
  We conducted a single-centre randomized-controlled study in a French University Hospital, from April 2011 to March 2012. The anaesthesia technique was randomly allocated to patients scheduled for carotid artery endarterectomy under regional anaesthesia (ropivacaine 4.75mg/mL): superficial cervical block in the Control group, and ultrasound-guided intermediate cervical block in the Echo group. The main outcome measure was the percentage of surgery performed without supplemental topical anaesthesia. The secondary outcomes were: rate of conversion to general anaesthesia, amount of supplemental topical lidocaine and block-related complications. P<0.05 was considered significant.
  
  
  RESULTS
  Demographic data for the 86 patients included [mean (SD) age 73 (11) years] did not differ between groups. Surgery was performed without supplemental topical lidocaine in 23% and 7% of the patients in the Echo and Control groups, respectively (P=0.068). Conversion to general anaesthesia for inadequate analgesia was needed in 0 and 2 patients in the Echo and Control groups, respectively. The mean dose of topical lidocaine was not different between groups. No complication directly related to a cervical block was observed.
  
  
  CONCLUSIONS
  Ultrasound-guided intermediate cervical plexus block and superficial cervical blocks performed for carotid artery surgery seems to provide similar results, but this study was probably underpowered to detect any difference.
  
  
  BACKGROUND
  European Union Drug Regulating Authorities Clinical Trials (Eudra-CT) registration number: 2010-A 01490-39.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Besançon, University of Franche-Comté, 3, boulevard Alexander-Fleming, 25000 Besançon, France. Electronic address: aalilet@hotmail.fr.
authors.forename: Arslane
authors.initials: A
authors.lastname: Alilet
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Besançon, University of Franche-Comté, 3, boulevard Alexander-Fleming, 25000 Besançon, France. Electronic address: pascalpetit2000@gmail.com.
authors.forename: Pascal
authors.initials: P
authors.lastname: Petit
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Besançon, University of Franche-Comté, 3, boulevard Alexander-Fleming, 25000 Besançon, France. Electronic address: bdevaux@chu-besancon.fr.
authors.forename: Benedicte
authors.initials: B
authors.lastname: Devaux
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Besançon, University of Franche-Comté, 3, boulevard Alexander-Fleming, 25000 Besançon, France. Electronic address: cdurandjoly@chu-besancon.fr.
authors.forename: Corinne
authors.initials: C
authors.lastname: Joly
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Besançon, University of Franche-Comté, 3, boulevard Alexander-Fleming, 25000 Besançon, France; EA 3920 and SFR-FED 4234, University of Franche-Comté, 3, boulevard Alexander-Fleming, 25000 Besançon, France. Electronic address: emmanuel.samain@univ-fcomte.fr.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Samain
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Besançon, University of Franche-Comté, 3, boulevard Alexander-Fleming, 25000 Besançon, France; EA 3920 and SFR-FED 4234, University of Franche-Comté, 3, boulevard Alexander-Fleming, 25000 Besançon, France. Electronic address: spilifloury@orange.fr.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Pili-Floury
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Besançon, University of Franche-Comté, 3, boulevard Alexander-Fleming, 25000 Besançon, France; EA 3920 and SFR-FED 4234, University of Franche-Comté, 3, boulevard Alexander-Fleming, 25000 Besançon, France. Electronic address: gbesch@chu-besancon.fr.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Besch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000577:Amides; D000763:Anesthesia, Caudal / Q000379:methods*; D000779:Anesthetics, Local; D016894:Endarterectomy, Carotid / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D011446:Prospective Studies; D000077212:Ropivacaine; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine
keywords: Analgesia; Carotids/carotid surgery; Regional anaesthesia; Ultrasound techniques