Evaluation of the effect of carotid sinus blockade on hemodynamic stability in carotid surgery: A retrospective study

This study assesses the effect of carotid sinus blockade applied with a local anesthetic on hemodynamic parameters during carotid endarterectomy (CEA) operations performed under general anesthesia. The medical records of patients who underwent CEA under general anesthesia between January 2020 and December 2022, were retrospectively reviewed. It was recorded whether the patients received carotid sinus block with 2 mL of 2% prilocaine. Intraoperative and 48-hour postoperative hemodynamic data were examined in the patients included in the study. A total of 129 patients were evaluated in the study, with 70 patients who received carotid sinus blockade (Group I) and 59 patients who did not receive blockade (Group II) during CEA. The comparison of heart rate variability immediately before clamping, immediately after clamping, and at 5, 10, and 20 minutes post-clamping indicated a significantly greater reduction in Group II compared to Group I (P < .05). In the postoperative period, the total dose of glyceryl trinitrate administered was 40.8 ± 31.9 mg in Group I and 53 ± 17.2 mg in Group II, showing a statistically significant difference (P = .001). Additionally, blood pressure measurements during this period were significantly higher in Group II than in Group I (P < .05). While the application of a local anesthetic during CEA appears to provide better intraoperative heart rate and postoperative blood pressure control, attributing these results solely to local anesthesia may not be entirely accurate. Hemodynamic instability observed during and after CEA is influenced by various factors.