Journals / Interdisciplinary Medical Journal / 2022 / Cilt: 13 - Sayı: 45

Our results of carotid endarterectomy under cervical block: a first application in an Anatolian medical center

Servikal blok altında karotis endarterektomi operasyonu sonuçlarımız: Anadolu’da bir merkezde ilk uygulama

Pages
97–103
Publication Date
2022-04-07
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Conclusion: With increasing experience, carotid endarterectomy can be performed safely under regional cervical block.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: Carotid endarterectomy can be performed under general anesthesia, regional cervical block, combined local-regional or local infiltration anesthesia.
📊
Key Findings & Data:Methods: Between September 2020 and January 2020, a total of 61 patients who underwent carotid endarterectomy were examined retrospectively.
💡
Conclusion & Impact:Conclusion: With increasing experience, carotid endarterectomy can be performed safely under regional cervical block.
🔬Design:Research Article
📍Scope:2020 Verileri
⚙️Variables:Karotis endarterektomi · rejyonel anestezi · inme

Abstract

Objective: Carotid endarterectomy can be performed under general anesthesia, regional cervical block, combined local-regional or local infiltration anesthesia. The aim of our research is to share our experience of patients who underwent carotid endarterectomy under regional cervical block. Methods: Between September 2020 and January 2020, a total of 61 patients who underwent carotid endarterectomy were examined retrospectively. The patients’ postoperative early results within the first 30 days were evaluated. Age, sex, risk factors, the usage of shunt, duration of the operation, neurological events, morbidity and mortality were all evaluated. Results: The data of 61 patients were analyzed retrospectively. Fifteen of the patients were female and forty-six were male. The mean age of the patients was calculated as 61.6±9.1(48-88) years. Fifty-one of the patients were symptomatic. Ten of the patients were asymptomatic, however they had a carotid stenosis of 70 percent or above. In 11 of the 61 patients, carotid endarterectomy was performed bilaterally, so a total of 72 carotid endarterectomies were performed in 61 patients. The mean duration of the procedure was 77.6±19.7 minutes, and the average time of a clamp on the carotid artery was 29.4±11.5 minutes. Major neurological events, bleeding, infections or death, were seen in none of the discharged patients within 1 month postoperatively. Conclusion: With increasing experience, carotid endarterectomy can be performed safely under regional cervical block.

Özet

Amaç: Karotis endarterektomi operasyonu genel anestezi ile uygulanabildiği gibi, bölgesel uygulanabilen; servikal rejyonel blok, lokal-rejyonel kombine anestezi ya da lokal infiltrasyon anestezisi altında yapılabilir. Bu çalışmada rejyonel blok uygulaması ile karotis endarterektomi uygulama deneyimlerimizi sunmayı amaçlıyoruz. Yöntem: Eylül 2020- Ocak 2022 tarihleri arasında karotis arterine endarterektomi operasyonu yapılan 61 hastanın cerrahi sonrası 30 gün süreyle erken dönem sonuçları retrospektif irdelenmiştir. Hastalara ait yaş, cinsiyet, risk faktörleri, şant kullanımı, operasyon süresi, nörolojik olaylar, mortalite ve morbidite değerlendirilmiştir. Bulgular: Toplam 61 hastanın verileri retrospektif olarak incelenmiştir. Hastalardan 15’i kadın, 46’sı erkekti. Ortalama yaş 61.6±9.1 (48-88) yıl olarak hesaplandı. Semptomatik hasta sayısı 51 idi. 10 hasta asemptomatik olup stenoz derecesi %70’in üzerindeydi. 11 hastada her iki tarafa endarterektomi uygulandı. Toplam olarak 72 karotis endarterektomi operasyonu gerçekleştirildi. Ortalama işlem süresi 77.6±19.7 dakika, karotis klemp süresi 29.4±11.5 dakika olarak hesaplandı. Taburcu edilen hiçbir hastada postoperatif ilk ay içinde majör nörolojik olay, kanama, enfeksiyon ya da ölüm ile karşılaşılmadı. Sonuç: Karotis endarterektomi operasyonu artan tecrübe ile birlikte rejyonel servikal blok altında güvenle gerçekleştirilebilir.

🔖

Cite This Article

BEYAZ, M. O., URFALI, S., KAYA, S., ORUÇ, D., ÇÖMEZ, M., HAKİMOĞLU, S., KOYUNCU, O., MELEK, I., FANSA, İ. (2022). Our results of carotid endarterectomy under cervical block: a first application in an Anatolian medical center. Interdisciplinary Medical Journal, Cilt: 13 - Sayı: 45, 97–103. https://ajindex.com/articles/887546

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (6)

  1. Beyaz MO, Agacfidan A, Onel M, et al. Is there any association between EBV infection and carotid artery stenosis? Cor Vasa 2021;63:535–539
  2. Ugurlucan M, Filik ME, Caglar IM, Zencirci E, Sayin OA, Aydiner O, et al. Carotid endarterectomy using a “homeconstructed” shunt for patients intolerant to crossclamping. Surg Today 2015;45(3):284-9.
  3. Lomivorotov VV, Shmyrev VA, Nepomniashchikh VA. Regional versus general anesthesia for carotid endarterectomy: do we need another randomized trial?. J Cardiothorac Vasc Anesth 2019; 33(4): 943-4.
  4. Grieff AN, Dombrovskiy V, Beckerman W, Ventarola D, Truong H, Huntress L et al. Regional anesthesia is associated with cranial nerve ınjury in carotid endarterectomy. Ann Vasc Surg 2020 pii: S0890-5096(20)30010-8. doi: 10.1016/j.avsg.2019.12.033. (Epubahead of print). Vieira-Andrade JD, Rocha-Neves JP, Macedo JP, Dias-Neto MF. onset of neurological deficit during carotid clamping with carotid endarterectomy under regional anesthesia ıs not a predictor of carotid restenosis. Ann Vasc Surg 2019; 61: 193-202. Clinical alert: benefit of carotid endarterectomy for patients with high-grade stenosis of the internal carotid artery. National Institute of Neurological Disorders and Stroke Stroke and Trauma Division. North American Symptomatic Carotid Endarterectomy Trial (NASCET) investigators. Stroke. 1991 Jun;22(6):816-7. doi: 10.1161/01.str.22.6.816. PMID: 2057984. Bond R, Rerkasem K, Rothwell PM. Routine or selective carotid artery shunting for carotid endarterectomy (and different methods of monitoring in selective shunting). Stroke. 2003 Mar;34(3):824-5. doi: 10.1161/01.STR.0000059381.17983.77. Epub 2003 Feb 27. PMID: 12624319. Kalko Y, Kafali E, Aydin U, Kafa U, Kosker T, Basaran M, et al. Surgery of the carotid artery: local anaesthesia versus general anaesthesia. Acta Chir Belg 2007;107(1):53-7.
  5. Dakour-Aridi H, Gaber MG, Khalid M, Patterson R, Malas MB. Examination of the interaction between method of anesthesia and shunting with carotidend arterectomy. J Vasc Surg 2019. pii: S0741-5214(19)32305-5. doi: 10.1016/j.jvs.2019.08.248. [Epubahead of print] DakourAridi H, Paracha N, Nejim B, Locham S, Malas MB. Anesthetic type and hospital outcomes after carotid endarterectomy from the Vascular Quality Initiative database. J Vasc Surg 2018; 67(5):1419-28.
  6. Kim JW, Huh U, Song S, Sung SM, Hong JM, Cho A.Outcomes of carotid endarterectomy according to the anesthetic method: general versus regional anesthesia.Korean J Thorac Cardiovasc Surg