Comparison of Combined (Deep and Superficial) and Intermediate Cervical Plexus Block by Use of Ultrasound Guidance for Carotid Endarterectomy

Kavakli, Ali Sait; Öztürk, Nilgün; Ayoglu, Raif Umut; Sagdic, Kadir; Çakmak, Gül; İnanoğlu, Kerem; Emmıler, Mustafa

doi:10.1053/j.jvca.2015.07.032

Cited by 29 publications

(25 citation statements)

References 17 publications

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“…The intermediate cervical plexus block should lead to lower morbidity, and its application with ultrasound control should be more accurate and more comfortable for patients. 11,12,17 Our study has some limitations. The structure of the questionnaire was relatively simple and therefore did not always reflect in detail the degree of satisfaction.…”

Section: Discussionmentioning

confidence: 92%

“…Moreover, most of these articles compared various techniques of locoregional anesthesia. [11][12][13] Only two studies compared LA with GA. 14,15 Unlike our report, neither of these studies detected significant differences in patient satisfaction between LA and GA. The overwhelming majority of patients were satisfied with both anesthetic techniques.…”

Section: Discussionmentioning

confidence: 99%

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Patient Satisfaction with General versus Local Anesthesia during Carotid Endarterectomy

Mraček

Kletečka

Holečková

et al. 2019

J Neurol Surg A Cent Eur Neurosurg

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Background and Study Aims Both general and local anesthesia are used in our department for carotid endarterectomy (CEA). The decision as to which anesthetic technique to use during surgery is made individually. The aim of our study was to evaluate patient satisfaction and preference with the anesthesia type used. Material and Methods The satisfaction of a group of 205 patients with regard to anesthesia used and their future preferences were evaluated prospectively through a questionnaire. The reasons for dissatisfaction were assessed. Results CEA was performed under general anesthesia (GA) in 159 cases (77.6%) and under local anesthesia (LA) in 46 cases (22.4%). In the GA group, 148 patients (93.1%) were satisfied; 30 patients (65.2%) in the LA group were satisfied (p < 0.0001). The reason for dissatisfaction with GA were postoperative nausea and vomiting (7 patients), postoperative psychological alteration (3), and fear of GA (1). The reasons for dissatisfaction with LA were intraoperative pain (9 patients), intraoperative discomfort and stress (5), and intraoperative breathing problems (2). Of the GA group, 154 (96.9%) patients would prefer GA again, and of the LA group, 28 (60.9%) patients would prefer LA if operated on again (p < 0.0001). Overall, 172 patients (83.9%) would prefer GA in the future, and 33 patients (16.1%) would prefer LA. Conclusion Overall patient satisfaction with CEA performed under both GA and LA is high. Nevertheless, in the GA group, patient satisfaction and future preference were significantly higher. Both GA and LA have advantages and disadvantages for CEA. An optimal approach is to make use of both anesthetic techniques based on their individual indications and patient preference.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Patient Satisfaction with General versus Local Anesthesia during Carotid Endarterectomy

Mraček

Kletečka

Holečková

et al. 2019

J Neurol Surg A Cent Eur Neurosurg

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“…A patient who had been considered to have a higher risk for general anesthesia because of Eisenmenger syndrome had been operated under continuous cervical plexus block, and any complication had not been encountered. Cervical plexus block is a preferred anesthetic method for carotid artery surgery [12, 13]. However use of these methods for CBT surgery may harbor some contraindications.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic considerations for carotid body tumors surgery

Kavakli

Öztürk

2016

North Clin Istanbul

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OBJECTIVE:Carotid body tumors (CBT) are benign tumors that originate from neural non-chromaffin cells that are typically localized near carotid bifurcation. Surgical removal of the tumor is the most appropriate treatment. General anesthesia is preferred anesthetic technique for CBT surgery. Basic elements of anesthetic management are protection of hemodynamic stability and maintaining cerebral perfusion pressure (CPP). The aim of this study was to evaluate anesthetic management of CBT surgery and present the literature knowledge.METHODS:The study included 10 consecutive patients with diagnosis of CBT who underwent surgery at Antalya Training and Research Hospital, in Antalya, Turkey, between 2013 and 2016. Preoperative demographic details; comorbidities; side of surgical site; duration of operation; length of intensive care unit (ICU) and hospital stay; change of intraoperative blood pressure; use of inotropic drugs, blood products, and analgesics; postoperative visual analogue scale (VAS) pain score; and complications were recorded.RESULTS:According to Shamblin classification, 3 tumors were type I and the remaining 7 were type II. Tumors were located on right side in 6 patients, and on left in 4. Blood loss sufficient to require transfusion was observed in 1 patient. Average intraoperative blood loss was 287±68 mL. Tachycardia and hypertension were observed in 1 patient; bradycardia and hypotension were seen in 4 patients. Infusion for inotropic support was administered to 1 patient. Mean duration of operation was 109±20 minutes. Mean VAS score was 4±1, mean ICU tramadol consumption was 80±25 mg. Duration of stay in ICU and hospital were 2.4±1.1 hours and 3.8±0.7 days, respectively. Mortality and neurological complications were not seen in postoperative period.CONCLUSION:CBT surgery requires close and complex anesthesia management. Protection of hemodynamic stability against sudden hemodynamic changes, monitoring, and maintaining CPP are the most important aspects of anesthetic management.

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“…Although regional anesthesia have some procedural complications such as temporary unilateral diaphragmatic and vocal cord paralysis, neural injuries and epidural, and subarachnoid or intravascular injection of local anesthetic, it can be performed under ultrasound guidance with a high success rate and a low risk of procedural complications [6] even if the patients take dual antiplatelet therapy or they had a prior cervical surgery [7].…”

mentioning

confidence: 99%

A comment on "General anesthesia management in carotid endarterectomy surgery: a single center experience"

Kavakli¹

2017

Med-Science

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Comparison of Combined (Deep and Superficial) and Intermediate Cervical Plexus Block by Use of Ultrasound Guidance for Carotid Endarterectomy

Cited by 29 publications

References 17 publications

Patient Satisfaction with General versus Local Anesthesia during Carotid Endarterectomy

Patient Satisfaction with General versus Local Anesthesia during Carotid Endarterectomy

Anesthetic considerations for carotid body tumors surgery

A comment on "General anesthesia management in carotid endarterectomy surgery: a single center experience"

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