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    Ayman Refaat1, Ahmed EL-Marakby, Ahmed Farghaly2, Hossam ELShamaa3, Mohamed Ibrahim4, Mohamed Hamed Salem5
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    • Carotid Endarterectomy under Regional Anesthesia; Early Results

    Ayman Refaat1, Ahmed EL-Marakby, Ahmed Farghaly2, Hossam ELShamaa3, Mohamed Ibrahim4, Mohamed Hamed Salem5
    1Department of General and Vascular Surgery, Beni Suef University. 2Department of General and Vascular Surgery, Cairo University 3Department of Anesthesia, Faculty of Medicine, Cairo University. 4Department of Anesthesia, Faculty of Medicine, Ain Shams University. 5Department of Anesthesia, National Heart Institute, Cairo.

    Aim of the study: In this study we aimed to examine the efficacy of carotid Endarterectomy (CEA) that was done under regional anesthesia. And furthermore, we compared the efficacy and anesthesia-related complications associated with the two different regional anesthetic techniques; the cervical plexus block (CPB) and the cervical epidural (CE). Material and Methods: From January 2012 to June 2015, 30 patients (19 men and 11 women) had Carotid endarterectomy (CEA) done under regional anesthesia. We recorded the peri and postoperative data and studied the outcome of the procedure. Patients were classified into 2 groups; Group I included 20 patients who had the CEA under combined deep and superficial cervical plexuses block (CPB), while Group II included the remaining 10 had their CEA under cervical epidural anesthesia (CE). Patients were followed up for 1 year. Results: No perioperative mortality. No major stroke was detected in all cases. We recorded only one case of minor stroke (3.3%). Cranial nerve concussion postoperatively with significant chocking (hypoglossal nerve affection) occurred only in a single patient. In terms of anesthesia related complications; significant postoperative hypotension was detected in 4 patients in both groups (13.3%) only one in Group I (5%) and 3 (30%) patients in groups II we also recorded one patient of Laryngeal nerve injury in group I and none in group II. Primary patency rate was 100% (30/30), 100% (29/30) & 95% (28/30) at 1, 6 & 12 months respectively. Conclusion: CEA under regional anesthesia is safe procedure with low rate of complications. Both CPB and CE are very effective anesthetic techniques but CPB is easier and with lower rate of anesthetic related complications than CE. Kewy Words: Carotid endarterectomy, Cervical blaok, Cervical eipidual.

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