Prospective Observational Study after Eversion Carotid Endarterectomy with Ultrasound-Guided Deep-Intermediate...

Area of Science:

• Neurology
• Anesthesiology
• Vascular Surgery

Background:

• Carotid endarterectomy is a common procedure to prevent stroke.
• General anesthesia and deep sedation carry risks, especially in elderly or comorbid patients.
• Regional anesthesia offers a potential alternative for awake carotid endarterectomy.

Purpose of the Study:

• To describe the anesthetic and surgical technique of eversion carotid endarterectomy under intermediate-deep cervical plexus block with sedation.
• To analyze the intraoperative and postoperative outcomes of this technique.

Main Methods:

• Prospective observational study of 30 patients undergoing unilateral eversion carotid endarterectomy.
• Anesthesia via ultrasound-guided intermediate-deep cervical plexus block and low-dose sedation.
• Monitoring of hemodynamic and neurological variables (cerebral oximetry).
• Assessment of postoperative pain, complications, and length of stay.

Main Results:

• Stable hemodynamic parameters and cerebral oximetry throughout the procedure.
• Low postoperative pain scores (≤3).
• Low incidence of major complications (3.3%) within 30 days.
• 40% incidence of residual nerve block, with most resolving.

Conclusions:

• Intermediate-deep cervical plexus block with sedation is an effective and safe anesthetic for awake eversion carotid endarterectomy.
• This technique provides stable intraoperative conditions and good postoperative pain control.
• It represents a viable alternative to general anesthesia for selected patients.