Successfully Managed Carotid Endarterectomy with Shunting Under Ultrasound Guided Carotid Sheath Block Combined with Superficial Cervical Plexus Block

Özet

Carotid endarterectomy (CEA) is the best treatment option in patients with high grade carotid artery stenosis. The assessment of patient’s consciousness in awake patient is still the gold standard for cerebral functions. Here, we report a case of a 73-year-old man who had left sided weakness 10 days ago. Investigations revealed bilateral carotid stenosis with a 90% stenosis on the right internal carotid artery and a 60% stenosis on the left side. He underwent semi-urgent CEA under combined ultrasound guided carotid sheath block (U-CSB) with superficial cervical plexus block (U-SCPB). No additional local anesthetic and/or systemic sedo-analgesic agent(s) were required during surgery. Application of CSB combined with SCPB, which provided excellent satisfaction for surgeon and patient, can be performed safely and rapidly for CEA under ultrasound guidance. Further studies are needed to demonstrate the reliability and effectiveness of this new technique.