• Vincent J Umbrain, Viola L van Gorp, Eric Schmedding, Erik E Debing, Karl von Kemp, Pierre M van den Brande, and Frédéric Camu.
• Department of Anesthesiology (V.J.U., V.L.V.G., F.C.), Academisch Ziekenhuis, Vrije Universiteit Brussel, Laarbeeklaan, Brussels, Belgium. Vincent.Umbrain@az.vub.ac.be
• Reg Anesth Pain Med. 2004 Jul 1;29(4):312-6.

ObjectiveTo examine the effect of 225 mg (7.5 mg/mL), 150 mg (5 mg/mL), and 112.5 mg (3.75 mg/mL) ropivacaine on quality of cervical plexus block during carotid endarterectomy.MethodsPatients (n = 93) scheduled for carotid endarterectomy were randomized to receive a cervical plexus block with deep infiltration of 10 mL and superficial infiltration of 20-mL volumes of ropivacaine 7.5, 5.0, or 3.75 mg/mL. Pain, coughing, hemodynamic consequences of the block, postoperative visual analog scores, and pain satisfaction index were recorded. If necessary, anesthesia supplements with aliquots of 3 mL lidocaine 1% were given during surgery.ResultsIncidences of coughing and hoarseness were similar in all groups. More local anesthetic infiltrations were required in the ropivacaine 3.75-mg/mL and 5-mg/mL groups. Postoperatively, no intragroup differences were observed. A trend toward better pain satisfaction was observed in the ropivacaine 7.5-mg/mL group.ConclusionThe best quality of cervical plexus block associated with the smallest incidence of pain for patients undergoing carotid endarterectomy was obtained with 30 mL of 225 mg and 150 mg of ropivacaine, respectively.

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