Cervical plexus anesthesia for carotid endarterectomy: comparison of ropivacaine and mepivacaine.

Abstract

PURPOSE:

To evaluate the effectiveness of cervical plexus block performed with ropivacaine 0.75% or 1%, or mepivacaine 2%.

METHODS:

In a prospective, randomized, double-blind study, 60 patients received deep cervical plexus block with 0.2 ml x kg(-1) divided among C2-C4 injections using ropivacaine 0.75% and 1% or mepivacaine 2%. A blinded observer recorded loss of pin-prick sensation every minute in the C2-C4 dermatomes until readiness for surgery. Then, a superficial cervical block was performed with 0.15 ml x kg(-1) lidocaine 1%. The need for intraoperative supplemental analgesia and degree of pain and time of first postoperative pain medication were also recorded.

RESULTS:

General anesthesia was not required to complete surgery in any case. No differences in the need for intraoperative supplemental analgesia was observed (7, 6, and 9 patients with ropivacaine 0.75% and 1% or mepivacaine 2%, respectively). Readiness to surgery required 15 (10-25) min with ropivacaine 0.75%, 18 (8-20) min with ropivacaine 1%, and 15 (5-20) min with mepivacaine 2% (P = NS); while patients asked for first postoperative pain 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 block characteristics similar to those of mepivacaine 2%, but with the advantage of longer postoperative pain relief.

• Authors: A Leoni, S Magrin, G Mascotto, A Rigamonti, G Gallioli, F Muzzolon, G Fanelli, A Casati
• Journal: Canadian journal of anaesthesia = Journal canadien d'anesthesie (Can J Anaesth) Vol. 47 Issue 2 Pg. 185-7 (Feb 2000) ISSN: 0832-610X [Print] United States
• PMID: 10674516 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Amides
• Anesthetics, Local
• Ropivacaine
• Mepivacaine

Topics

• Aged
• Aged, 80 and over
• Amides (pharmacology)
• Anesthetics, Local (pharmacology)
• Cervical Plexus
• Double-Blind Method
• Endarterectomy, Carotid
• Female
• Humans
• Male
• Mepivacaine (pharmacology)
• Middle Aged
• Nerve Block
• Prospective Studies
• Ropivacaine