• M M Marrocco-Trischitta, G Bandiera, S Camilli, F Stillo, C Cirielli, and P Guerrini.
• Department of Vascular Surgery and Pathology, Istituto Dermopatico dell Immacolata, I.D.I.-IRCCS, Via dei Monti di Creta, 104, 10067 Rome, Italy.
• Eur J Vasc Endovasc Surg. 2001 Nov 1;22(5):405-9.

Objectivesto prospectively evaluate the safety and efficacy of remifentanil during regional anaesthesia for carotid endarterectomy.Methodstwenty-eight consecutive patients underwent carotid endarterectomy with combined superficial and deep cervical plexus block supplemented with continuous intravenous 0.04 microg.kg(-1).min(-1)remifentanil infusion. Depth of sedation was monitored using the Observer's Assessment of Alertness/Sedation Scale (OAA/S). The degree of pain, discomfort and anxiety was self-assessed by the patients using a horizontal visual analogue scale.Resultsall patients experienced adequate comfort and analgesia. No local anaesthetic supplementation was necessary. No patient had a OAA/S score lower than 4 (with 5=awake/alert to 1=asleep). Respiratory depression did not occur. Selective shunting was required in four cases. No patient was converted to general anaesthesia. There were no permanent neurological deficits, cardiopulmonary complications or deaths.Conclusionremifentanil as a supplement to regional anaesthesia for carotid endarterectomy, provides comfort and analgesia without hampering mental status evaluation.Copyright 2001 Harcourt Publishers Limited.

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