engleski

Regional anaesthesia for carotid endarterectomy.

Background. Atherosclerotic carotid disease is one of the leading causes of mortality in the elderly, in western countries. The main cause of carotid stenosis is atherosclerotic disease, which puts patients at risk for cerebral and cardiac complications. Carotid endarterectomy is a preventive surgicalprocedure, which can be performed under general anesthe- sia (GA) or regional (RA) anesthesia. The aim of this study was to show the anesthetic potential of a superficial cervical block and postoperative analgesia management. Prospective research was performed on 10 patients who had undergone carotid endarterectomy under regional anesthe- sia (superficial cervical block) at the Departement of Surgery, General Hospital Slavonski Brod, during the year 2006. The average age was 62 and ASA II or III were used. After preoperative preparation and informed consent all patients recieved 2, 5–5 mg i.v. midazolam for premedication. Superficial cervical blocks were performed by using 0, 25% levobupivacaine (1, 5 mg/ kg + 0, 2 mg epinephrine). Invasive blood pressure monitoring was obtained before RA and 50mg meperidine was given i.v. as analgesia for the block procedure. Blood pressure, level of consciouness, speech ability, contralateral motoric potential, pain score VAS (visual analog scale)were monitored continously during surgery and every half hour postoperatively in the ICU. Conclusion. Nine patients had unchanged neurogical status with excellent hemodynamic stabillity (blood pressure and pulse oscillation less 20 %). Anesthetic potential or effectiveness was sufficient ; VAS was 1–2 except during the surgical approach to the perivascular sheeth when documented as VAS 3–6. Postoperatively, during the following eight hours, there was no need for analgesic supplementation (VAS level 1–2). Based on the results, a superficial cervical block was and is the choice of anesthesia for carotid endarterectomy.

regional anesthesia ; carotid endarterectomy ; cervical block

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