Cardiovascular Complications of Carotid Endarterectomy under Regional Anaesthesia Technique:a Comparison of Cervical Plexus Block and Cervical Epidural Anaesthesia

Overview

Objective:
The aim of this retrospective study was to evaluate a haemodynamic profile of the patients during carotidendarterectomy under regional anaesthesia technique and to compare the perioperative cardiovascular stability andcomplication rate of cervical plexus block (CPB) and cervical epidural anaesthesia (CEA).Design: Retrospective clinical study.Setting: Department of Cardiovascular Anaesthesia and Intensive Care, Na Homolce Hospital, Prague, Czech Republic,Department of Transplant Surgery, IKEM, Prague, Czech Republic.Material and Methods: A total of 529 carotid artery endarterectomies performed under regional anaesthesia in 1998–2003period were included into this retrospective study. A total of 313 procedures were performed using cervical plexus block,while cervical epidural anaesthesia was used in 216 operations. The evaluated parameters included the systolic, diastolicand mean arterial pressures, heart rate before, during and after the procedure. The circulatory complications, includingchest pain, ST segment depression and acute myocardial infarction in the perioperative period were also evaluated. Theobtained data were analyzed statistically using chi-square test.Results: Hypertension requiring a pharmacological intervention was noted in 181 patients in a CPB group (57.8%) and in25 patients in a CEA group (11.6%) respectively; P

Key words:
carotid endarterectomy –⁠ cervical plexus block –⁠ cevical epidural anaesthesia –⁠ haemodynamic status –perioperative myocardial ischaemia