Anaesthesia for carotid endarterectomy. USG guided superfici
Carotid endarterectomy carries a significant risk of intraoperative brain ischaemia. Various methods for
intraoperative cerebral function monitoring can be utilized, but the assessment of the patient’s consciousness remains
the easiest and most available method, requiring that the patient remain awake and under local/regional anaesthesia.
The aim of this study was to compare infiltration anaesthesia with an ultrasound-guided superficial/combined cervical
plexus block for patient safety and comfort.
Ninety-eight patients scheduled for carotid endarterectomy were randomly assigned to receive either
infiltration anaesthesia performed by the surgeon or an US-guided superficial/combined cervical plexus block. The
pain intensity using the numerical rating scale (NRS), the volume of local anaesthetic used and the anaesthesia-related
complications were recorded. The data were analysed using selected statistical tools.
In the US-guided group, a significantly lower volume of local anaesthetic was used (25 mL vs. 30 mL), and lower
mean (1 vs. 3) and maximal (2 vs. 6) NRS scores were observed. However, hoarseness, cough and difficulty swallowing
were significantly more frequent among those patients (90% vs. 27%, 30% vs. 12%, and 36% vs. 6%, respectively).
Compared with infiltration anaesthesia, an US-guided superficial/combined cervical plexus block is an
effective method for improving the comfort of the patient and the surgeon. The technique is safe, relatively simple
and easy to master and requires little time to perform.....