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[Carotid surgery under locoregional anesthesia].
O Goëau-Brissonnière1, F Bacourt, J F Renier
1Service de Chirurgie générale, digestive et vasculaire, Hôpital Ambroise Paré, Boulogne.
Presse Medicale (Paris, France : 1983)
|November 11, 1989
Summary
Cervical plexus block is a preferred anesthesia for carotid endarterectomy due to fewer complications and better patient outcomes compared to epidural anesthesia. This technique ensures patient vigilance, improving surgical quality and reducing embolism risk.
Area of Science:
- Neurosurgery
- Anesthesiology
Context:
- Carotid endarterectomy is a surgical procedure to remove plaque from carotid arteries.
- Regional anesthesia offers an alternative to general anesthesia for this procedure.
- Patient selection and anesthetic technique are crucial for successful outcomes.
Purpose:
- To compare the safety and efficacy of cervical epidural anesthesia versus cervical plexus block for carotid endarterectomy.
- To evaluate the occurrence of intraoperative cerebral ischemia and neurological events.
- To assess anesthetic-related complications, mortality, and morbidity.
Summary:
- Eighty-five carotid endarterectomies were performed under regional anesthesia (cervical epidural vs. cervical plexus block).
- Intraoperative neurological events were more frequent with carotid back pressure ≤ 25 mmHg, necessitating shunting in 14.1% of cases.
- Cervical plexus block demonstrated fewer hemodynamic repercussions and was easier to perform, with no recorded anesthetic complications, nil mortality, and low neurological morbidity.
Impact:
- Cervical plexus block is favored for carotid endarterectomy due to its safety profile and ease of administration.
- Preserved patient vigilance during surgery allows for improved focus on surgical quality, reducing embolism risk.
- This approach is particularly beneficial for high-risk patients undergoing carotid endarterectomy.