• Paweł Mądro, Alina Dąbrowska, Jarosław Jarecki, and Piotr Garba.
• Department of Anaesthesiology and Intensive Therapy, 4th Military Teaching Hospital with Outpatient Clinic in Wrocław, Poland. pmadro@op.pl.
• Anaesthesiol Intensive Ther. 2016 Jan 1; 48 (4): 234-238.

BackgroundCarotid endarterectomy carries a significant risk of intraoperative brain ischaemia. Various methods for intraoperative cerebral function monitoring can be utilized, but the assessment of the patient's consciousness remains the easiest and most available method, requiring that the patient remain awake and under local/regional anaesthesia. The aim of this study was to compare infiltration anaesthesia with an ultrasound-guided superficial/combined cervical plexus block for patient safety and comfort.MethodsNinety-eight patients scheduled for carotid endarterectomy were randomly assigned to receive either infiltration anaesthesia performed by the surgeon or an US-guided superficial/combined cervical plexus block. The pain intensity using the numerical rating scale (NRS), the volume of local anaesthetic used and the anaesthesia-related complications were recorded. The data were analysed using selected statistical tools.ResultsIn the US-guided group, a significantly lower volume of local anaesthetic was used (25 mL vs. 30 mL), and lower mean (1 vs. 3) and maximal (2 vs. 6) NRS scores were observed. However, hoarseness, cough and difficulty swallowing were significantly more frequent among those patients (90% vs. 27%, 30% vs. 12%, and 36% vs. 6%, respectively).ConclusionsCompared with infiltration anaesthesia, an US-guided superficial/combined cervical plexus block is an effective method for improving the comfort of the patient and the surgeon. The technique is safe, relatively simple and easy to master and requires little time to perform.

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