Anesthesia
Conditions
Keywords
cervical plexus block, Endarterectomy, Carotid
Brief summary
Cervical plexus blocks are regional methods used in carotid endarterectomy. Cervical plexus blocks consist of three blocks: superficial, intermediate and deep. These three blocks can be used alone or combined. The aim of this study is to evaluate the effectiveness of ultrasound-guided intermediate and deed cervical plexus block in patients undergoing carotid endarterectomy.
Detailed description
Carotid endarterectomy is a surgical method used to treat occlusive lesions of the carotid. Regional anesthesia is preferred because it allows for consciousness control and neurological examination during the operation. Cervical plexus blocks are regional methods used in carotid endarterectomy. It is a regional technique in which the cervical spinal nerves (C2-C3-C4) are blocked with a local anesthetic agent from different regions. Cervical plexus blocks consist of three blocks: superficial, intermediate and deep, depending on the depth at which the local anesthetic agent is infiltrated. According to the preference of the clinician for the purpose of anesthesia, these three blocks can be used separately or combined. It is mentioned that all three blocks provide sufficient anesthesia for carotid endarterectomy surgery to be performed. In the study, investigators planned to evaluate the effectiveness of ultrasound-guided intermediate and deep cervical plexus blocks in patients undergoing carotid endarterectomy by comparing the number of patients who need additional local anesthetics.
Interventions
PROCEDUREIntermediate cervical plexus block
Intermediate cervical plexus block will be applied in transverse plane using posterior approach at C4.
PROCEDUREDeep cervical plexus block
Deep cervical plexus block will be appliedin transverse plane using anterior approach at C2-3-4.
Sponsors
Istanbul University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Caregiver, Investigator, Outcomes Assessor)
Intervention model description
Randomized, Prospective
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients scheduled for carotid endarterectom y surgery.
Exclusion criteria
* Local infection * Previous ipsilateral surgery * Radiotherapy * Conversion to general anesthesia * Known bleeding disorders * Known allergy of local anesthetic
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of patient needed supplemental local anesthetic | Intraoperative 2-3 hours | If patients complain about pain above visual analog scale 3, 4ml 1% lidocaine is injected by surgeon. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of blocks' application | Up to 15 minutes | time from the insertion of probe to the removal of needle from skin |
| Region where patient needs supplemental local anesthetic | Intraoperative 2-3 hours | Region where supplemental lidocaine is injected by surgeon |
| Amount of remifentanil | Intraoperative 2-3 hours | Amount of remifentanil (0.02mcg/kg/min) infused during surgery for sedation. |
| Amount of supplemental local anesthetic | Intraoperative 2-3 hours | If patients complain about pain above visual analog scale 3, 4ml 1% lidocaine is injected by surgeon. |
| Complications | Up to 24 hours | Hematoma, dysphagia, hoarseness, facial paralysis, Horner's syndrome, intravascular or intrathecal injection |
| Patient's satisfaction | Up to 24 hours | Likert scale:1-5 (1: very dissatisfied, 5: very satisfied) |
| Surgeon's satisfaction | Up to 24 hours | Likert scale:1-5 (1: very dissatisfied, 5: very satisfied) |
| Pain assessment | Intraoperative 2-3 hours | Pain assessment will be assessed using visual analog scale (VAS 0 to 10; 0: no pain, 10: the worst pain imaginable ) |
Countries
Turkey (Türkiye)
Outcome results
None listed