BACKGROUND AND OBJECTIVES: Cervical plexus blocks are performed for carotid surgery to allow neurological assessment of the awake patient. The aim of this study was to establish the frequency of success, complications, and patient acceptance of the technique. METHODS: One thousand superficial and deep cervical blocks were performed in 924 patients having carotid artery surgery. Data about the blocks were recorded prospectively and patients were followed up postoperatively by an independent anesthesiologist to assess patient acceptance of the technique. RESULTS: Lidocaine was the most frequently used anesthetic (88%). Surgical supplementation of the blocks was required in 53% of operations. Six blocks (0.6%) had clinical evidence of intravascular injection of local anesthetic. Sedation was required in 66% of operations and conversion to general anesthesia occurred in 25 (2.5%) of operations. Ninety-one percent of patients reported no problems with the block, and 93% stated that they would have the same anesthetic for any future similar surgery. CONCLUSIONS: We conclude that superficial and deep cervical plexus block has a high success rate, low complication rate, and high patient acceptance rate. Caution should, however, be exercised to ensure a low intravascular injection rate which is of most concern with this technique, because blood was aspirated in 30% of patients during performance of the block.
BACKGROUND AND OBJECTIVES: Cervical plexus blocks are performed for carotid surgery to allow neurological assessment of the awake patient. The aim of this study was to establish the frequency of success, complications, and patient acceptance of the technique. METHODS: One thousand superficial and deep cervical blocks were performed in 924 patients having carotid artery surgery. Data about the blocks were recorded prospectively and patients were followed up postoperatively by an independent anesthesiologist to assess patient acceptance of the technique. RESULTS:Lidocaine was the most frequently used anesthetic (88%). Surgical supplementation of the blocks was required in 53% of operations. Six blocks (0.6%) had clinical evidence of intravascular injection of local anesthetic. Sedation was required in 66% of operations and conversion to general anesthesia occurred in 25 (2.5%) of operations. Ninety-one percent of patients reported no problems with the block, and 93% stated that they would have the same anesthetic for any future similar surgery. CONCLUSIONS: We conclude that superficial and deep cervical plexus block has a high success rate, low complication rate, and high patient acceptance rate. Caution should, however, be exercised to ensure a low intravascular injection rate which is of most concern with this technique, because blood was aspirated in 30% of patients during performance of the block.
Authors: Thomas Rössel; Christopher Uhlig; Jörg Pietsch; Stefan Ludwig; Thea Koch; Torsten Richter; Peter Markus Spieth; Stephan Kersting Journal: BMC Anesthesiol Date: 2019-11-26 Impact factor: 2.217