Ultrasound-guided intermediate cervical plexus block for postoperative analgesia in patients undergoing carotid endarterectomy under general anesthesia: a case-control study

Abstract

The aim of this study is to compare intravenous analgesia (IVA) and intermediate cervical plexus block (ICPB) in terms of acute pain scores and opioid consumption in patients undergoing carotid endarterectomy (CEA) under general anesthesia. Materials and Method:Following the induction of anesthesia, dexketoprofen trometamol 50 mg was administered before the surgical incision, and paracetamol 1 g was given at the end of the surgery and continued at 6 hour intervals for group IVA. Whereas, ultrasound-guided intermediate cervical plexus block was performed in ICPB group. VAS scores, morphine consumption, length of stay, and patient satisfaction status were compared.Results: A total of 109 patients (57 in the IVA group and 52 in the ICPB group) between January 2015 and June 2021 were enrolled. The mean VAS score after extubation was significantly lower in the ICPB group (4.1±1.4 vs 1.2±0.8, p=0.005). Total morphine consumption was found to be significantly lower in the ICPB group (13.1±4.4 mg vs 3.9±2.4 mg, p<0.001). The hospital stay was 3.1±1.3 days in the IVA group, while it was 2.2±0.9 days in the ICPB group (p=0.0014). The patients in the ICPB group were found to be significantly more satisfied (3.4±1.4 vs 1.2±0.8, p<0.001). Conclusion:Intermediate cervical plexus block provides lower acute pain scores and lower opioid consumption compared to intravenous analgesia in patients undergoing CEA under general anesthesia. In addition, this combined technique shortens the ICU and hospital length of stay and improves patient satisfaction.