Document Detail


Regional anesthesia for carotid surgery.
MedLine Citation:
PMID:  18784492     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Joanne Guay
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in anaesthesiology     Volume:  21     ISSN:  1473-6500     ISO Abbreviation:  Curr Opin Anaesthesiol     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-11     Completed Date:  2009-01-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8813436     Medline TA:  Curr Opin Anaesthesiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  638-44     Citation Subset:  IM    
Affiliation:
Department of Anesthesia, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada. joanne.guay@umontreal.ca
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Anesthetics, Local / 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:
0/Anesthetics, Local; 0/Vasoconstrictor Agents; 51-43-4/Epinephrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Ophthalmic regional anaesthesia.
Next Document:  The toxicity of local anesthetics: the place of ropivacaine and levobupivacaine.