- Ultrasound-guided superficial cervical plexus block under dexmedetomidine sedation versus general anesthesia for carotid endarterectomy: a retrospective pilot study
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Wangseok Do, Ah-Reum Cho, Eun-Jung Kim, Hyae-Jin Kim, Eunsoo Kim, Heon-Jeong Lee
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Yeungnam Univ J Med. 2018;35(1):45-53. Published online June 30, 2018
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DOI: https://doi.org/10.12701/yujm.2018.35.1.45
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 Abstract
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- Background
Carotid endarterectomy (CEA) has been performed under regional and general anesthesia (GA). The general anesthesia versus local anesthesia for carotid surgery study compared the two techniques and concluded that there was no difference in perioperative outcomes. However, since this trial, new sedative agents have been introduced and devices that improve the delivery of regional anesthesia (RA) have been developed. The primary purpose of this pilot study was to compare intraoperative hemodynamic stability and postoperative outcomes between GA and ultrasound-guided superficial cervical plexus block (UGSCPB) under dexmedetomidine sedation for CEA.
Methods
Medical records from 43 adult patients who underwent CEA were retrospectively reviewed, including 16 in the GA group and 27 in the RA group. GA was induced with propofol and maintained with sevoflurane. The UGSCPB was performed with ropivacaine under dexmedetomidine sedation. We compared the intraoperative requirement for vasoactive drugs, postoperative complications, pain scores using the numerical rating scale, and the duration of hospital stay.
Results
There was no difference between groups in the use of intraoperative antihypertensive drugs. However, intraoperative inotropic and vasopressor agents were more frequently required in the GA group (p<0.0001). In the GA group, pain scores were significantly higher during the first 24 h after surgery (p<0.0001 between 0-6 h, p<0.004 between 6-12 h, and p<0.001 between 12-24 h). The duration of hospital stay was significantly more in the GA group (13.3±4.6 days in the GA group vs. 8.5±2.4 days in the RA group, p<0.001).
Conclusion
In this pilot study, intraoperative hemodynamic stability and postoperative outcomes were better in the RA compared to the GA group.
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Citations
Citations to this article as recorded by  - Outcomes of Dexmedetomidine with Local Regional Anesthesia in Carotid Endarterectomy
Samik H. Patel, Vikram L. Sundararaghavan, Amber M. Pawlikowski, Jeremy Albright, Jason M. Adams, Michael J. Heidenreich, Robert J. Beaulieu, Abdulhameed Aziz
Annals of Vascular Surgery.2023; 89: 174. CrossRef - Anesthetic Management of a Patient Undergoing Cochlear Implantation With Superficial Cervical Plexus Block and Sedation: A Case Report
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Journal of Clinical Medicine.2021; 10(23): 5479. CrossRef - Plexus anesthesia versus general anesthesia in patients for carotid endarterectomy with patch angioplasty: Protocol for a systematic review with meta-analyses and Trial Sequential Analysis of randomized clinical trials
M. S. Marsman, J. Wetterslev, F. Keus, D. van Aalst, F. G. van Rooij, J. M.M. Heyligers, F. L. Moll, A. Kh. Jahrome, P. W.H.E Vriens, G. G. Koning
International Journal of Surgery Protocols.2020; 19: 1. CrossRef
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