A. Leoni et al., Cervical plexus anesthesia for carotid endarterectomy: comparison of ropivacaine and mepivacaine, CAN J ANAES, 47(2), 2000, pp. 185-187
Citations number
10
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
Journal title
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE
Purpose: To evaluate the effectiveness of cervical plexus block performed w
ith ropivacaine 0.75% or 1%, or mepivacaine 2%,
Methods: In a prospective randomized, double-blind study, 60 patients recei
ved deep cervical plexus block with 0.2 ml.kg(-1) divided among C-2-C-4 inj
ections using ropivacaine 0.75% and 1% or mepivacaine 2%, A blinded observe
r recorded loss of pin-prick sensation every minute in the C-2-C-4 dermatom
es unlit readiness for surgery, Then, a superficial cervical block was perf
ormed with 0.15 ml.kg(-1) lidocaine 1%. The need for intraoperative supplem
ental analgesia and degree of pain and time of first postoperative pain med
ication were also recorded.
Results: General anesthesia was not required to complete surgery in any cas
e, No differences in the need for intraoperative supplemental analgesia was
observed (7, 6, and 9 patients with ropivacaine 0.75% and 1% or mepivacain
e 2%, respectively). Readiness to surgery required 15 (10 - 25) min with ro
pivacaine 0.75%, 18 (8 - 20) min with ropivacaine 1%, and 15 (5 - 20) min w
ith mepivacaine 2% (P = NS); while patients asked for first postoperative p
ain medication after 10 (4 - 13) hr and 9 (6.5 - 11) hr with ropivacaine 0.
75% and 1% compared with 5 (0 - 8) hr with mepivacaine 2% (P < 0.05),
Conclusion: Ropivacaine 0.75% or 1% are appropriate choices when performing
cervical plexus anesthesia for carotid endarterectomy, providing nerve blo
ck characteristics similar to those of mepivacaine 2%, but with the advanta
ge of longer postoperative pain relief.