Combination of Superficial Cervical Plexus Block and Local Infiltration Anesthesia in Carotid Endarterectomy: A Retrospective Analysis

Objective: We retrospectively investigated the efficacy of combination of superficial cervical plexus block (CPB) and local infiltration anesthesia in patients underwent carotid endarterectomy (CEA). Methods: After ethics approval, we searched medical records of patients who underwent CEA with combination of superficial CPB and local infiltration anesthesia performed before surgery. Data were given as mean +/- SD or number(%). Results: There were 22 patients (age: 68.9 +/- 9.2 yr, weight: 73.7 +/- 11.1 kg) who underwent CEA under defined anesthesia method from June 2007 to April 2011. The amounts of local anesthetics used for combination anesthesia and intraoperative supplementary anesthesia (95.4%) were 29.9 +/- 11.2 mL and 12.1 +/- 5.6 mL, respectively. All patients received fentanyl (87.5 +/- 52.1 mu g) and midazolam (1.8 +/- 0.6 mg), and nine patients (40.9%) received propofol (<2 mg/kg/hr) intraoperatively. Surgery was completed successfully in all patients. Pain scores (010) of eighteen patients (81.8%) who were transferred to recovery unit were <= 3 without receiving any analgesic. Myocardial infarction, stroke or death were not observed. Conclusions: Carotid endarterectomy can be successfully performed under combined anesthesia including superficial CPB and local infiltration anesthesia. In addition to this, the percentage of supplemental anesthetic drug requirement is high intraoperatively and pain scores of patients are low postoperatively.