Ultrason Eşliğinde Derin Servikal Pleksus Blokajıyla Yapılan Karotis Endarterektomi: Erken ve Orta Dönem Sonuçlarımız

Objective: Carotid artery stenosis is one of the main reasons of stroke. In this study, early and mid-term results of our carotid endarterectomy operations, which were performed with ultrasound-guided regional anesthesia, were evaluated. Material and Methods: A total of, 32 patients who were diagnosed with carotid artery stenosis with Doppler ultrasonography or magnetic resonance angiography in our clinic between February 2011 and July 2013 were included in the study. All patients had ASA2-3 scores. Superficial and deep cervical blocks were made under ultrasonography guidance. Ten milliliters of local anesthetic agent was given subcutaneously. Ten milliliters of 1% prilocaine was injected subcutaneously for superficial cervical block. Topical anesthetic solution was injected over the carotid bifurcation. Carotid endarterectomy was performed by either shunt or clamping. Arteriotomy closure was either made primarily, or with saphenous vein patch. Postoperative control was made with Doppler ultrasonography at 3rd-6th-12nd months. Results: Average clamping time was 16.8±2.9 min, operation time was 45±11 min, intensive care unit and hospital stays were 1.3 and 4.8 days, respectively. In early postoperative period, hoarseness, cough, facial paralysis, hematoma and difficulty of swallowing were seen. All of them resolved before the time of discharge. One patient was discharged with hemiparesis. Conclusion: Ultrasound-guided deep cervical block is an effective and safe method. Easy application of this procedure, extra anesthetic efficiency of deep cervical block, and few cardiac and neurologic complications are important advantages of this method.