Seraglio P, Campostella F A
Servizio di Anestesia, Rianimazione e Terapia Antalgica, ASL n. 4 Alto Vicentino, Ospedale S. Camillo de Lellis, Schio (VI), Italy.
Minerva Anestesiol. 2001 Sep;67(9 Suppl 1):65-70.
To evaluate the efficacy and security of the cervical plexus block and the continuous cervical peridural anaesthesia in carotid surgery, using ropivacaine as local anaesthetic.
90 patients (ASA II-III, age 67-84) who had signed informed consent were randomised in two groups. In Group C continuous cervical plexus block was performed using ropivacaine 0,75% 2,5 mg/kg. In Group P continuous cervical peridural anaesthesia was performed, at level C6-C7 or C7-T1, introducing the catheter for 5 cm into the epidural space and injecting in 20 min ropicavacine 0,5% 0,9 mg/kg together with 50-100 g of fentanyl. ECG, HR, arterial blood pressure, neurological status of conscious patient and eventual complications were all monitored.
Demographical data, duration of surgery and level of anaesthesia were all uniform in both groups. At the onset of the block the values of the systolic arterial blood pressure were significantly lower in Group P compared to Group C. One case of intradural injection of ropivacaine was reported and one case of intravascular injection, without remaining deficits. There were no perioperative complications.
cervical plexus block and continuous cervical peridural anaesthesia performed with ropivacaine are both effective for anaesthesia in carotid surgery. Ropivacaine, for its minor cardiotoxicity, yields eventual complications related to the two methods, less severe.
以罗哌卡因作为局部麻醉药，评估颈丛阻滞和连续颈段硬膜外麻醉在颈动脉手术中的有效性和安全性。
90例签署知情同意书的患者（ASA II-III级，年龄67 - 84岁）被随机分为两组。C组使用0.75%罗哌卡因2.5mg/kg进行连续颈丛阻滞。P组在C6 - C7或C7 - T1水平进行连续颈段硬膜外麻醉，将导管置入硬膜外腔5cm，在20分钟内注入0.5%罗哌卡因0.9mg/kg及50 - 100μg芬太尼。监测心电图、心率、动脉血压、清醒患者的神经状态及可能出现的并发症。
两组的人口统计学数据、手术时间和麻醉水平均一致。在阻滞开始时，P组的收缩动脉血压值显著低于C组。报告了1例罗哌卡因硬膜内注射和1例血管内注射病例，均无遗留神经功能缺损。围手术期无并发症发生。
罗哌卡因用于颈丛阻滞和连续颈段硬膜外麻醉在颈动脉手术麻醉中均有效。罗哌卡因因其心脏毒性较小，两种方法相关的并发症最终都较轻。
