Enhancing postoperative analgesia in carotid endarterectomy patients: The potential of ultrasound-guided carotid sheath block combined with superficial cervical plexus block: A randomised trial
Background and Aims: Carotid endarterectomy (CEA) is a common procedure conducted under regional anaesthesia, providing real-time cerebral function monitoring. Many different combinations of regional cervical blocks exist, and most offer adequate analgesia in intraoperative and postoperative recover...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-09-01
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| Series: | Indian Journal of Anaesthesia |
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| Online Access: | https://journals.lww.com/10.4103/ija.ija_834_23 |
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| author | Anamarija Kruc Lada Lijovic Matteo Skrtic Iva Pazur Nikola Perisa Tomislav Radocaj |
| author_facet | Anamarija Kruc Lada Lijovic Matteo Skrtic Iva Pazur Nikola Perisa Tomislav Radocaj |
| author_sort | Anamarija Kruc |
| collection | DOAJ |
| description | Background and Aims:
Carotid endarterectomy (CEA) is a common procedure conducted under regional anaesthesia, providing real-time cerebral function monitoring. Many different combinations of regional cervical blocks exist, and most offer adequate analgesia in intraoperative and postoperative recovery. This research compares a superficial cervical plexus block (SCB) alone and combined with an ultrasound (US)-guided carotid sheath block (CSB). The primary objective was to explore the length of the sensory block after combining SCB and CSB.
Methods:
Patients scheduled for nonemergency CEA surgery were randomised into two cohorts. The Subject group (28 participants) received US-guided CSB and SCB. The Control group (31 participants) received only an SCB. Both groups received 0.5% levobupivacaine (2 mg/kg) along with 2% lidocaine (2 mg/kg). The sensory block time and its initiation, analgesia and neutrophil-to-lymphocyte ratio (NLR) were recorded before and after the block. The numeric pain rating scale (NPRS) was used to evaluate analgesia every 2 h for 12 h post block. Analysis of variance, Mann–Whitney U or log-rank test was used to analyse the distinction of selected variables.
Results:
The demographic characteristics were comparable across the cohorts. The Subject group demonstrated a significantly accelerated onset of sensory block (P = 0.029) and an extended time to first analgesia (P = 0.003). The sensory block was also substantially extended in the Subject group (P = 0.040). Postoperative pain (NPRS ≥1) within the first 12 h was more recurrent in the Control group (P = 0.048). NLR showed minimal disparity between the groups (P = 0.125).
Conclusion:
Combining SCB and US-guided CSB effectively and safely extends postoperative analgesia for CEA surgery. |
| format | Article |
| id | doaj-art-64b571010b70487b9aa9fb80a1744f4d |
| institution | Kabale University |
| issn | 0019-5049 0976-2817 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj-art-64b571010b70487b9aa9fb80a1744f4d2025-01-23T09:23:03ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172024-09-0168980180810.4103/ija.ija_834_23Enhancing postoperative analgesia in carotid endarterectomy patients: The potential of ultrasound-guided carotid sheath block combined with superficial cervical plexus block: A randomised trialAnamarija KrucLada LijovicMatteo SkrticIva PazurNikola PerisaTomislav RadocajBackground and Aims: Carotid endarterectomy (CEA) is a common procedure conducted under regional anaesthesia, providing real-time cerebral function monitoring. Many different combinations of regional cervical blocks exist, and most offer adequate analgesia in intraoperative and postoperative recovery. This research compares a superficial cervical plexus block (SCB) alone and combined with an ultrasound (US)-guided carotid sheath block (CSB). The primary objective was to explore the length of the sensory block after combining SCB and CSB. Methods: Patients scheduled for nonemergency CEA surgery were randomised into two cohorts. The Subject group (28 participants) received US-guided CSB and SCB. The Control group (31 participants) received only an SCB. Both groups received 0.5% levobupivacaine (2 mg/kg) along with 2% lidocaine (2 mg/kg). The sensory block time and its initiation, analgesia and neutrophil-to-lymphocyte ratio (NLR) were recorded before and after the block. The numeric pain rating scale (NPRS) was used to evaluate analgesia every 2 h for 12 h post block. Analysis of variance, Mann–Whitney U or log-rank test was used to analyse the distinction of selected variables. Results: The demographic characteristics were comparable across the cohorts. The Subject group demonstrated a significantly accelerated onset of sensory block (P = 0.029) and an extended time to first analgesia (P = 0.003). The sensory block was also substantially extended in the Subject group (P = 0.040). Postoperative pain (NPRS ≥1) within the first 12 h was more recurrent in the Control group (P = 0.048). NLR showed minimal disparity between the groups (P = 0.125). Conclusion: Combining SCB and US-guided CSB effectively and safely extends postoperative analgesia for CEA surgery.https://journals.lww.com/10.4103/ija.ija_834_23carotid endarterectomycarotid sheath blockcervical plexus blockpostoperative painregional anaesthesiaultrasound |
| spellingShingle | Anamarija Kruc Lada Lijovic Matteo Skrtic Iva Pazur Nikola Perisa Tomislav Radocaj Enhancing postoperative analgesia in carotid endarterectomy patients: The potential of ultrasound-guided carotid sheath block combined with superficial cervical plexus block: A randomised trial Indian Journal of Anaesthesia carotid endarterectomy carotid sheath block cervical plexus block postoperative pain regional anaesthesia ultrasound |
| title | Enhancing postoperative analgesia in carotid endarterectomy patients: The potential of ultrasound-guided carotid sheath block combined with superficial cervical plexus block: A randomised trial |
| title_full | Enhancing postoperative analgesia in carotid endarterectomy patients: The potential of ultrasound-guided carotid sheath block combined with superficial cervical plexus block: A randomised trial |
| title_fullStr | Enhancing postoperative analgesia in carotid endarterectomy patients: The potential of ultrasound-guided carotid sheath block combined with superficial cervical plexus block: A randomised trial |
| title_full_unstemmed | Enhancing postoperative analgesia in carotid endarterectomy patients: The potential of ultrasound-guided carotid sheath block combined with superficial cervical plexus block: A randomised trial |
| title_short | Enhancing postoperative analgesia in carotid endarterectomy patients: The potential of ultrasound-guided carotid sheath block combined with superficial cervical plexus block: A randomised trial |
| title_sort | enhancing postoperative analgesia in carotid endarterectomy patients the potential of ultrasound guided carotid sheath block combined with superficial cervical plexus block a randomised trial |
| topic | carotid endarterectomy carotid sheath block cervical plexus block postoperative pain regional anaesthesia ultrasound |
| url | https://journals.lww.com/10.4103/ija.ija_834_23 |
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