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The hemodynamic effect of intermediate cervical plexus block compared to general anesthesia in high risk patients with carotid endarterectomy

DANIELA BANDIĆ PAVLOVIĆ ; Department of Anesthesiology, Reanimatology and Intensive Care, Clinical Hospital Center „Zagreb”, Kišpatićeva 12, 10000 Zagreb, Croatia
DINKO TONKOVIĆ ; Department of Anesthesiology, Reanimatology and Intensive Care, University hospital „Sveti Duh”, Ulica Sveti Duh 64, Zagreb, Croatia
SANJA SAKAN ; Department of Anesthesiology, Reanimatology and Intensive Care, Clinical Hospital Center „Zagreb”, Kišpatićeva 12, 10000 Zagreb, Croatia
ŽELJKA MARTINOVIĆ ; Department of Anesthesiology, Reanimatology and Intensive Care, University hospital „Sisters of charity“, Vinogradska cesta 29, Zagreb, Croatia

Abstract

Background and purpose: Preventive open carotid surgery is amainstay
treatment for stenosis of internal carotid artery. Anesthesia management is
crucial in these patients with many comorbidities. Both, general or regional
anesthesia are the correct choice. The purpose of our trialwas to compare the hemodynamic stability of intermediate cervical plexus block relative to
general anesthesia in ASA III and ASA IV patients.

Materials and methods: Prospective study, approved by ethics committee,
was conducted in the University hospital Zagreb from 2006 till 2010. Eighty nine high risk patients with carotid endarterectomy were enrolled. Thirty five patients were performed in the intermediate cervical block and fifty four in general anesthesia. From medical records, following data were collected – age, sex, ASA status. Mean arterial pressure was calculated. The change of mean arterial pressure during the operation for more than 20% was considered as hemodynamic instability. Postoperative hospital stay was recorded.

Results: Significantly higher hemodynamic stability is found in the
group of patientswith intermediate cervical block (chi-square test=27,763,
p<0,01). The median intensive care unit stay was 2,47 days for general
anesthesia group, compared to one day for intermediate cervical group.
Conclusion: General anesthesia and intermediate cervical block provide

effective anesthesia condition for carotid endarterectomy. According to the
results of our trial, intermediate cervical block compared to general anesthesia is more hemodynamic stable, associated with shorter hospital stay.

Keywords

intermediate cervical block; general anesthesia; carotid endarterectomy

Hrčak ID:

106019

URI

https://hrcak.srce.hr/106019

Publication date:

1.6.2013.

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