| Regional anesthesia for carotid surgery. | |
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MedLine Citation:
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PMID: 18784492 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE OF REVIEW: Evidence from retrospective studies suggests that regional anesthesia reduces the risks of major complications associated with carotid endarterectomy compared with general anesthesia, namely: stroke, stroke/death, death and myocardial infarction. RECENT FINDINGS: A superficial cervical plexus block is the regional anesthetic technique of choice. It is as efficacious as a combined (superficial and deep) cervical plexus block and carries substantially less risk of inducing a life-threatening complication from the block placement than a cervical epidural or a deep cervical plexus block. Lidocaine, mepivacaine, bupivacaine and ropivacaine are all suitable agents for this block but bupivacaine provides the longest duration of postoperative analgesia. The addition of epinephrine 1: 300,000 (3.75 microg/ml) reduces maximal blood concentrations of lidocaine and bupivacaine without inducing any adverse hemodynamic effects. SUMMARY: The anesthesiologist should learn how to place a superficial cervical plexus block. The technique is easy to master, effective and carries a low risk of inducing a serious complication. |
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Authors:
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Joanne Guay |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Current opinion in anaesthesiology Volume: 21 ISSN: 1473-6500 ISO Abbreviation: Curr Opin Anaesthesiol Publication Date: 2008 Oct |
Date Detail:
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Created Date: 2008-09-11 Completed Date: 2009-01-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8813436 Medline TA: Curr Opin Anaesthesiol Country: United States |
Other Details:
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Languages: eng Pagination: 638-44 Citation Subset: IM |
Affiliation:
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Department of Anesthesia, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada. joanne.guay@umontreal.ca |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anesthetics, Local
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administration & dosage* Cervical Plexus Conscious Sedation / methods Endarterectomy, Carotid / methods* Epinephrine / administration & dosage Humans Monitoring, Intraoperative / standards Nerve Block / methods* Randomized Controlled Trials as Topic Vasoconstrictor Agents / administration & dosage |
| Chemical | |
Reg. No./Substance:
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0/Anesthetics, Local; 0/Vasoconstrictor Agents; 51-43-4/Epinephrine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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