The number of injections does not influence absorption of bupivacaine after cervical plexus block for carotid endarterectomy

Gratz, Irwin; Deal, Edward; Larijani, Ghassem E.; Domsky, Richard; Goldberg, Michael E.

doi:10.1016/j.jclinane.2004.07.009

Cited by 8 publications

(4 citation statements)

References 14 publications

(12 reference statements)

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“…The number of injections does not influence LA absorption as reflected by the Cmax and Tmax. Single injection technique can cause less pain during block and may be associated less systemic absorbtion of LA (45) ; but there is no relationship between the number of injections and overall block efficacy (14) . DCPB can be performed by landmark or US-guided technique (9) .…”

Section: Deep Cervical Plexus Block (Dcpb)mentioning

confidence: 99%

Anesthesia Management for Carotid Endarterectomy: Review Article

Yilmaz¹

2019

ejcm

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Atherosclerotic carotid artery disease is responsible from 20% to 25% of ischemic stroke events. Open carotid surgery and stent insertion are two main types of treatment procedures. Carotid endarterectomy (CEA) can be performed under general anaesthesia, regional anaesthesia (interscalen block, cervical plexus block either by landmark technique or by US guidance), combination of general and regional anaesthesia, regional anaesthesia with combination of periferic block. The aim of all anesthesic techniques is to prevent pain during the three painful periods (1. Skin incision, 2. Insertion of a retromandibular retractor, 3. Perivascular preparation) during CEA). All techniques have their own advantages and disadvantages. But there is no certain data about which one is superior to other. There is no consensus on anaesthetic choice for CEA. At present regional anaesthesia versus general anaesthesia for patients undergoing CEA is still debate topic. Improvements in medical theraphy, use of cerebral monitoring, better timing for surgery after ischemic events, better surgical techniques, increased use of ultrasound for regional anaesthesia improve procedural outcomes. Despite these improvements, anaesthesia management is still deciding according to surgeon and anaesthesiologist preferences, the patient's satisfaction and the conditions in the hospitals where we work.

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Section: Deep Cervical Plexus Block (Dcpb)mentioning

confidence: 99%

Anesthesia Management for Carotid Endarterectomy: Review Article

Yilmaz¹

2019

ejcm

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“…Der sogenannte "tiefe" Block, bei dem ein Lokalanästhetikum direkt an die Nervenwurzeln von C2-5 injiziert wird, kann als Einfachinjektion (C3 oder C4-5) [31]oder mittels multipler Injektionen (C2, C3, C4) [15] durchgeführt werden. Die Einfachinjektion scheint hierbei weniger schmerzhaft zu sein und im Vergleich zur Technik mit multiplen Injektionen keinen Nachteil hinsichtlich der Effektivität des Blocks zu haben.…”

Section: Tiefer Zervikalblockunclassified

Regionalanästhesie zur Karotischirurgie

Nawratil

Opperer

2017

Anaesthesist

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“…A short-bevelled, 50 mm block needle connected to a nerve stimulator is inserted perpendicular to the skin consecutively at C2, C3, and C4. A current of 0.5 mA may elicit neck muscle contractions; ipsilateral head twitch; 28 elevation and internal rotation of the scapula; 27 paraesthesia over the upper arm, shoulder, 33 neck; or paraesthesia radiating up to the ear. By identifying diaphragmatic muscle response, a nerve stimulator may avoid administration of the LA directly onto the phrenic nerve, thereby avoiding phrenic nerve palsy.…”

Section: Deep Cervical Plexus Blockmentioning

confidence: 99%

Regional anaesthesia for carotid endarterectomy

Stoneham

Stamou

Mason

2015

British Journal of Anaesthesia

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Summary Regional anaesthesia is a popular choice for patients undergoing carotid endarterectomy (CEA). Neurological function is easily assessed during carotid cross-clamping; haemodynamic control is predictable; and hospital stay is consistently shorter compared with general anaesthesia (GA). Despite these purported benefits, mortality and stroke rates associated with CEA remain around 5% for both regional anaesthesia and GA. Regional anaesthetic techniques for CEA have improved with improved methods of location of peripheral nerves including nerve stimulators and ultrasound together with a modification in the classification of cervical plexus blocks. There have also been improvements in local anaesthetic, sedative, and arterial pressure-controlling drugs in patients undergoing CEA, together with advances in the management of patients who develop neurological deficit after carotid cross-clamping. In the UK, published national guidelines now require the time between the patient's presenting neurological event and definitive treatment to 1 week or less. This has implications for the ability of vascular centres to provide specialized vascular anaesthetists familiar with regional anaesthetic techniques for CEA. Providing effective regional anaesthesia for CEA is an important component in the armamentarium of techniques for the vascular anaesthetist in 2014.

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The number of injections does not influence absorption of bupivacaine after cervical plexus block for carotid endarterectomy

Cited by 8 publications

References 14 publications

Anesthesia Management for Carotid Endarterectomy: Review Article

Anesthesia Management for Carotid Endarterectomy: Review Article

Regionalanästhesie zur Karotischirurgie

Regional anaesthesia for carotid endarterectomy

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