A unique anesthesia approach for carotid endarterectomy: Combination of general and regional anesthesia
Carotid endarterectomy (CEA), a preventable surgery, reduces the future risks of cerebrovascular stroWke in patients with marked carotid stenosis. Peri-operative management of such patients is challenging due to associated major co-morbidities and high incidence of peri-operative stroke and myocardi...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2014-01-01
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| Series: | Saudi Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.saudija.org/article.asp?issn=1658-354X;year=2014;volume=8;issue=2;spage=290;epage=293;aulast=Samanta |
| _version_ | 1818615458214969344 |
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| author | Sukhen Samanta Sujay Samanta Nidhi Panda Rudrashish Haldar |
| author_facet | Sukhen Samanta Sujay Samanta Nidhi Panda Rudrashish Haldar |
| author_sort | Sukhen Samanta |
| collection | DOAJ |
| description | Carotid endarterectomy (CEA), a preventable surgery, reduces the future risks of cerebrovascular stroWke in patients with marked carotid stenosis. Peri-operative management of such patients is challenging due to associated major co-morbidities and high incidence of peri-operative stroke and myocardial infarction. Both general anesthesia (GA) and local regional anesthesia (LRA) can be used with their pros and cons. Most developing countries as well as some developed countries usually perform CEA under GA because of technical easiness. LRA usually comprises superficial, intermediate, deep cervical plexus block or a combination of these techniques. Deep block, particularly, is technically difficult and more complicated, whereas intermediate plexus block is technically easy and equally effective. We did CEA under a combination of GA and LRA using ropivacaine 0.375% with 1 mcg/kg dexmedetomidine (DEX) infiltration. In LRA, we gave combined superficial and intermediate cervical plexus block with infiltration at the incision site and along the lower border of mandible. We observed better hemodynamics in intraoperative as well as postoperative periods and an improved postoperative outcome of the patient. So, we concluded that combination of GA and LRA is a good anesthetic technique for CEA. Larger randomized prospective trials are needed to support our conclusion. |
| first_indexed | 2024-12-16T16:34:13Z |
| format | Article |
| id | doaj.art-28c6b11eff6a48b198ec9dd9f34ae552 |
| institution | Directory Open Access Journal |
| issn | 1658-354X |
| language | English |
| last_indexed | 2024-12-16T16:34:13Z |
| publishDate | 2014-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Saudi Journal of Anaesthesia |
| spelling | doaj.art-28c6b11eff6a48b198ec9dd9f34ae5522022-12-21T22:24:31ZengWolters Kluwer Medknow PublicationsSaudi Journal of Anaesthesia1658-354X2014-01-018229029310.4103/1658-354X.130753A unique anesthesia approach for carotid endarterectomy: Combination of general and regional anesthesiaSukhen SamantaSujay SamantaNidhi PandaRudrashish HaldarCarotid endarterectomy (CEA), a preventable surgery, reduces the future risks of cerebrovascular stroWke in patients with marked carotid stenosis. Peri-operative management of such patients is challenging due to associated major co-morbidities and high incidence of peri-operative stroke and myocardial infarction. Both general anesthesia (GA) and local regional anesthesia (LRA) can be used with their pros and cons. Most developing countries as well as some developed countries usually perform CEA under GA because of technical easiness. LRA usually comprises superficial, intermediate, deep cervical plexus block or a combination of these techniques. Deep block, particularly, is technically difficult and more complicated, whereas intermediate plexus block is technically easy and equally effective. We did CEA under a combination of GA and LRA using ropivacaine 0.375% with 1 mcg/kg dexmedetomidine (DEX) infiltration. In LRA, we gave combined superficial and intermediate cervical plexus block with infiltration at the incision site and along the lower border of mandible. We observed better hemodynamics in intraoperative as well as postoperative periods and an improved postoperative outcome of the patient. So, we concluded that combination of GA and LRA is a good anesthetic technique for CEA. Larger randomized prospective trials are needed to support our conclusion.http://www.saudija.org/article.asp?issn=1658-354X;year=2014;volume=8;issue=2;spage=290;epage=293;aulast=SamantaCarotid endarterectomydexmedetomidineintermediate cervical plexus blocksuperficial cervical plexus block |
| spellingShingle | Sukhen Samanta Sujay Samanta Nidhi Panda Rudrashish Haldar A unique anesthesia approach for carotid endarterectomy: Combination of general and regional anesthesia Saudi Journal of Anaesthesia Carotid endarterectomy dexmedetomidine intermediate cervical plexus block superficial cervical plexus block |
| title | A unique anesthesia approach for carotid endarterectomy: Combination of general and regional anesthesia |
| title_full | A unique anesthesia approach for carotid endarterectomy: Combination of general and regional anesthesia |
| title_fullStr | A unique anesthesia approach for carotid endarterectomy: Combination of general and regional anesthesia |
| title_full_unstemmed | A unique anesthesia approach for carotid endarterectomy: Combination of general and regional anesthesia |
| title_short | A unique anesthesia approach for carotid endarterectomy: Combination of general and regional anesthesia |
| title_sort | unique anesthesia approach for carotid endarterectomy combination of general and regional anesthesia |
| topic | Carotid endarterectomy dexmedetomidine intermediate cervical plexus block superficial cervical plexus block |
| url | http://www.saudija.org/article.asp?issn=1658-354X;year=2014;volume=8;issue=2;spage=290;epage=293;aulast=Samanta |
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