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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
80
Intermediate cervical plexus block will be applied in transverse plane using posterior approach at C4.
Deep cervical plexus block will be appliedin transverse plane using anterior approach at C2-3-4.
Istanbul Faculty of Medicine
Istanbul, Turkey (Türkiye)
Number of patient needed supplemental local anesthetic
If patients complain about pain above visual analog scale 3, 4ml 1% lidocaine is injected by surgeon.
Time frame: Intraoperative 2-3 hours
Amount of supplemental local anesthetic
If patients complain about pain above visual analog scale 3, 4ml 1% lidocaine is injected by surgeon.
Time frame: Intraoperative 2-3 hours
Duration of blocks' application
time from the insertion of probe to the removal of needle from skin
Time frame: Up to 15 minutes
Region where patient needs supplemental local anesthetic
Region where supplemental lidocaine is injected by surgeon
Time frame: Intraoperative 2-3 hours
Amount of remifentanil
Amount of remifentanil (0.02mcg/kg/min) infused during surgery for sedation.
Time frame: Intraoperative 2-3 hours
Pain assessment
Pain assessment will be assessed using visual analog scale (VAS 0 to 10; 0: no pain, 10: the worst pain imaginable )
Time frame: Intraoperative 2-3 hours
Complications
Hematoma, dysphagia, hoarseness, facial paralysis, Horner's syndrome, intravascular or intrathecal injection
Time frame: Up to 24 hours
Patient's satisfaction
Likert scale:1-5 (1: very dissatisfied, 5: very satisfied)
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Time frame: Up to 24 hours
Surgeon's satisfaction
Likert scale:1-5 (1: very dissatisfied, 5: very satisfied)
Time frame: Up to 24 hours