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Prospective Observational Study after Eversion Carotid Endarterectomy with Ultrasound-Guided Deep-Intermediate Cervical Plexus Blockade

(1) Introduction: The aim was to describe the anesthetic and surgical technique of eversion carotid endarterectomy performed under intermediate-deep cervical block with sedation, and to analyze the intraoperative and postoperative results. (2) Material and Methods: Thirty cases of unilateral eversio...

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Autores principales: Vega Colón, María, López González, José Manuel, Jiménez Gómez, Bárbara María, Pico Veloso, Jandro, Fernández Mendez, Marta, Fernández Suárez, Félix Ezequiel, del Castro Madrazo, José Antonio, Álvarez Marcos, Francisco, Fajardo Pérez, Mario, Lin, Jui-An, Galluccio, Felice, Hou, Jin-De, Chan, Shun-Ming
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9601612/
https://www.ncbi.nlm.nih.gov/pubmed/36292433
http://dx.doi.org/10.3390/healthcare10101986
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author Vega Colón, María
López González, José Manuel
Jiménez Gómez, Bárbara María
Pico Veloso, Jandro
Fernández Mendez, Marta
Fernández Suárez, Félix Ezequiel
del Castro Madrazo, José Antonio
Álvarez Marcos, Francisco
Fajardo Pérez, Mario
Lin, Jui-An
Galluccio, Felice
Hou, Jin-De
Chan, Shun-Ming
author_facet Vega Colón, María
López González, José Manuel
Jiménez Gómez, Bárbara María
Pico Veloso, Jandro
Fernández Mendez, Marta
Fernández Suárez, Félix Ezequiel
del Castro Madrazo, José Antonio
Álvarez Marcos, Francisco
Fajardo Pérez, Mario
Lin, Jui-An
Galluccio, Felice
Hou, Jin-De
Chan, Shun-Ming
author_sort Vega Colón, María
collection PubMed
description (1) Introduction: The aim was to describe the anesthetic and surgical technique of eversion carotid endarterectomy performed under intermediate-deep cervical block with sedation, and to analyze the intraoperative and postoperative results. (2) Material and Methods: Thirty cases of unilateral eversion carotid endarterectomy (n = 30), performed between 2019–2020 in a tertiary center under intermediate-deep ultrasound-guided cervical plexus block and sedation, were prospectively observed and analyzed. Hemodynamic (blood pressure, heart rate) and neurological (cerebral oximetry) variables were measured in four intraoperative phases: at the beginning of the operation, prior to carotid clamping, after unclamping and at the end of the operation. We assessed acute postoperative pain in a numerical rating scale at 6, 12 and 24 h, early and 30-day complications, and length of stay. (3) Results: Baseline mean arterial pressure values were 100.4 ± 18 mmHg, pre-clamping 95.8 ± 14 mmHg, post-clamping 94.9 ± 11 mmHg, and at the end of the operation 102.4 ± 16 mmHg. Cerebral oximetry values were 61.7 ± 7/62.7 ± 8, 68.5 ± 9.6/69.1 ± 11.7 and 68.1 ± 10/68.1 ± 10 for the left and right hemispheres at baseline, pre- and post-clamping, respectively. The pain assessment showed a score less than or equal to 3. The incidence of residual nerve block, early complications, and major complications in the first 30 days was 40%, 16.7% and 3.3%, respectively. (4) Conclusions: The combination of intermediate-deep cervical plexus block and low-dose sedation is an effective and safe alternative in awake eversion carotid endarterectomy.
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spelling pubmed-96016122022-10-27 Prospective Observational Study after Eversion Carotid Endarterectomy with Ultrasound-Guided Deep-Intermediate Cervical Plexus Blockade Vega Colón, María López González, José Manuel Jiménez Gómez, Bárbara María Pico Veloso, Jandro Fernández Mendez, Marta Fernández Suárez, Félix Ezequiel del Castro Madrazo, José Antonio Álvarez Marcos, Francisco Fajardo Pérez, Mario Lin, Jui-An Galluccio, Felice Hou, Jin-De Chan, Shun-Ming Healthcare (Basel) Article (1) Introduction: The aim was to describe the anesthetic and surgical technique of eversion carotid endarterectomy performed under intermediate-deep cervical block with sedation, and to analyze the intraoperative and postoperative results. (2) Material and Methods: Thirty cases of unilateral eversion carotid endarterectomy (n = 30), performed between 2019–2020 in a tertiary center under intermediate-deep ultrasound-guided cervical plexus block and sedation, were prospectively observed and analyzed. Hemodynamic (blood pressure, heart rate) and neurological (cerebral oximetry) variables were measured in four intraoperative phases: at the beginning of the operation, prior to carotid clamping, after unclamping and at the end of the operation. We assessed acute postoperative pain in a numerical rating scale at 6, 12 and 24 h, early and 30-day complications, and length of stay. (3) Results: Baseline mean arterial pressure values were 100.4 ± 18 mmHg, pre-clamping 95.8 ± 14 mmHg, post-clamping 94.9 ± 11 mmHg, and at the end of the operation 102.4 ± 16 mmHg. Cerebral oximetry values were 61.7 ± 7/62.7 ± 8, 68.5 ± 9.6/69.1 ± 11.7 and 68.1 ± 10/68.1 ± 10 for the left and right hemispheres at baseline, pre- and post-clamping, respectively. The pain assessment showed a score less than or equal to 3. The incidence of residual nerve block, early complications, and major complications in the first 30 days was 40%, 16.7% and 3.3%, respectively. (4) Conclusions: The combination of intermediate-deep cervical plexus block and low-dose sedation is an effective and safe alternative in awake eversion carotid endarterectomy. MDPI 2022-10-10 /pmc/articles/PMC9601612/ /pubmed/36292433 http://dx.doi.org/10.3390/healthcare10101986 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Vega Colón, María
López González, José Manuel
Jiménez Gómez, Bárbara María
Pico Veloso, Jandro
Fernández Mendez, Marta
Fernández Suárez, Félix Ezequiel
del Castro Madrazo, José Antonio
Álvarez Marcos, Francisco
Fajardo Pérez, Mario
Lin, Jui-An
Galluccio, Felice
Hou, Jin-De
Chan, Shun-Ming
Prospective Observational Study after Eversion Carotid Endarterectomy with Ultrasound-Guided Deep-Intermediate Cervical Plexus Blockade
title Prospective Observational Study after Eversion Carotid Endarterectomy with Ultrasound-Guided Deep-Intermediate Cervical Plexus Blockade
title_full Prospective Observational Study after Eversion Carotid Endarterectomy with Ultrasound-Guided Deep-Intermediate Cervical Plexus Blockade
title_fullStr Prospective Observational Study after Eversion Carotid Endarterectomy with Ultrasound-Guided Deep-Intermediate Cervical Plexus Blockade
title_full_unstemmed Prospective Observational Study after Eversion Carotid Endarterectomy with Ultrasound-Guided Deep-Intermediate Cervical Plexus Blockade
title_short Prospective Observational Study after Eversion Carotid Endarterectomy with Ultrasound-Guided Deep-Intermediate Cervical Plexus Blockade
title_sort prospective observational study after eversion carotid endarterectomy with ultrasound-guided deep-intermediate cervical plexus blockade
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9601612/
https://www.ncbi.nlm.nih.gov/pubmed/36292433
http://dx.doi.org/10.3390/healthcare10101986
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