surgical benefits of cervical block anesthesia for carotid endartrectomy

ABSTRACT

This randomized study was performed to evaluate the benefits of cervical block anesthesia on the surgical technique and outcome of carotid endarterectomy [CEA] aiming to develop a safe and reliable anesthetic and surgical approach for patients undergoing CEA. From May 1997 to May 2001, 36 patients indicated for CEA due to the presence of internal carotid stenosis were randomized into two groups In group I [18 patients], CEA was done under cervical block anesthesia; while in group II [18 patients], CEA was done under general anesthesia. Hemodynamic measurements and stump pressure were estimated for all cases. The need for shunt, operative time, early postoperative complications and hospital stay was evaluated in both groups. In group I, there was more stable systolic and diastolic blood pressure during the operation. 89% of group I patients tolerated carotid cross clamping without the need for carotid shunt and this method was more accurate than the measurement of stump pressure. Shunt was used in 38.8% of group II patients and this resulted in an intimal dissection in two cases. The operative time was significantly less in group I than group II and discharge from the ICU was earlier