Superficial and deep cervical plexus block for carotid artery surgery: A prospective study of 1000 blocks

Davies, Melanie J.; Silbert, Brendan; Scott, David A.; Cook, Russell J.; Mooney, Patricia H.; Blyth, Carolyn

doi:10.1016/s1098-7339(97)80031-4

Cited by 88 publications

(46 citation statements)

References 9 publications

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“…Entsprechend des operativen Situs sollte bei Durchführung einer Regionalanästhesie die Ausdehnung der sensorischen Blockade die Dermatome C2-C4 beinhalten. Aufgrund der komplexen Innervation des Operationssitus durch Zervikalund auch Hirnnerven ist jedoch in den meisten Fällen eine intraoperative Supplementierung durch den Operateur erforderlich, da gerade die Hirnnervenanteile nicht ausreichend anästhesiert werden [19]. Somit stehen für die Karotischirurgie grundsätzlich die folgenden 3 Verfahren der Regionalanästhesie zur Auswahl:…”

Section: Regionalanästhesieverfahrenunclassified

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Anästhesie zur Karotischirurgie

et al. 2008

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Carotid endarterectomy (CEA) has remained the first choice of treatment in preventing ischemic stroke due to symptomatic stenosis of the internal carotid artery despite other new available options. During CEA patients are first and foremost at risk of cerebral as well as myocardial ischemia, therefore, maintenance of the oxygen supply to the brain and the myocardium is of outstanding importance requiring reliable monitoring of cerebral and cardiac function. The regional versus general anesthesia debate is an age-old one that has brought few definite answers regarding the impact on postoperative outcome of either anesthetic technique. Up to now, there is little evidence from only a few randomized clinical trials to demonstrate the superiority of either anesthetic technique with respect to outcome parameters. Because the level of evidence in favor of regional anesthesia during CEA can at least be rated between 1(-) and 2(+) the resulting recommendation is grade C. The purpose of the review is to highlight the characteristics and goals of anesthetic management during CEA.

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Section: Regionalanästhesieverfahrenunclassified

“…In Gefäßpunktionen in bis zu 66% der Fäl-le; die meistens jedoch ohne Folgen blieben [19]. Allerdings zeigten diese Erfahrungen auch, dass wiederholte Aspiration während der Injektion keinen zuverläs-sigen Schutz vor Fehlinjektion bietet.…”

Section: Epiduralanästhesieunclassified

Anästhesie zur Karotischirurgie

et al. 2008

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“…Although a superficial or a combined deep and superficial block has been recommended, evidence suggests that a combination of both blocks increases the frequency of local anesthetic (LA)-related complications [2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Pharmacokinetics of levobupivacaine 0.5% after superficial or combined (deep and superficial) cervical plexus block in patients undergoing minimally invasive parathyroidectomy

Pintarič

Koželj²,

Stanovnik³

et al. 2008

Journal of Clinical Anesthesia

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“…1,2 Surgeons prefer general anesthesia, as patients sleep throughout the procedure. Galbeman et al 3 compared surgeries done under general anesthesia and superficial cervical plexus block, and noted that there seemed to be advantages when using local anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Comparação da anestesia geral e bloqueio do plexo cervical superficial em tireoidectomias parciais

Mamede

Raful

2008

Rev. Bras. Otorrinolaringol.

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Thyroi dectomy under the effect of superficial cervical plexus block (SCPB) has met resistance. Aim: to compare variables in patients submitted to hemithyroidectomy under the effect of general anesthesia (GA) and SCPB. Case report and Methods: GA was used in 21 patients, and SCPB was used in another 21 patients. Following sedation, marcaine 0.5% with vasoconstrictor was used in the SCPB group. Intraoperative sedation with diazepam and metoprolol to control arterial pressure and cardiac frequency was given as needed. GA followed the standard method in the unit. Results: We found significant results (p<0.05, Student's ttest) for surgery time (GA -111.4 min; SCPB -125.5 min), anesthesia time (GA -154.1 min; SCPB -488.6 min), time in the surgery room (GA -15 min; SCPB -1 min), treatment costs (GA -R$203.2; SCPB -R$87.4), presence of bradycardia (GA -0; SCPB -23.8%) and laryngotracheal injury (GA -51; SCPB -0 %). We also found the following non-significant results: hospitalization time (GA -17.3; SCPB -15.1 hours); bleeding volume (GA -41,9 g; SCPB -47.6 g), size of the operative specimen (GA -52.1 cm3; SCPB -93.69 cm3) and patient satisfaction level (GA -3.8; SCPB -3.9). Conclusion: Although the incidence of bradycardia was higher (23.8%), SCPB was done for the resection of tumors measuring up to 348 cm3, at a lower cost and with no laryngotracheal injuries; these were present in 51% of patients undergoing GA.

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Superficial and deep cervical plexus block for carotid artery surgery: A prospective study of 1000 blocks

Cited by 88 publications

References 9 publications

Anästhesie zur Karotischirurgie

Anästhesie zur Karotischirurgie

Pharmacokinetics of levobupivacaine 0.5% after superficial or combined (deep and superficial) cervical plexus block in patients undergoing minimally invasive parathyroidectomy

Comparação da anestesia geral e bloqueio do plexo cervical superficial em tireoidectomias parciais

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