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Full Text: 
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¿µ³²ÀÇ´ëÇмúÁö Yeungnam Univ J Med 2018;35(1):45-53
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ORIGINAL ARTICLE
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Ultrasound-guided superficial cervical plexus block under
dexmedetomidine sedation versus general anesthesia for carotid
endarterectomy: a retrospective pilot study |
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Wangseok Do1, Ah-Reum Cho1, Eun-Jung Kim2, Hyae-Jin Kim1, Eunsoo Kim1, Heon-Jeong Lee1
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1Department of Anesthesia and Pain Medicine, Pusan National University, School of Medicine, Busan;
2Department of Dental Anesthesia and Pain Medicine, Pusan National University Dental Hospital, Dental Research Institute, Yangsan, Korea
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Corresponding Author: Ah-Reum Cho, Department of
Anesthesia and Pain Medicine, School of Medicine, Pusan
National University, 179, Gudeok-ro, Seo-gu, Busan 49241,
Korea
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Tel: +82-51-240-7399, Fax: +82-51-242-7466
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E-mail: archo@pusan.ac.kr
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Received: January 29, 2018, Revised: March 28, 2018
Accepted: April 9, 2018
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Abstract
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Background: Carotid endarterectomy (CEA) has been performed under regional and general anesthesia (GA).
The general anesthesia versus local anesthesia for carotid surgery study compared the two techniques and
concluded that there was no difference in perioperative outcomes. However, since this trial, new sedative
agents have been introduced and devices that improve the delivery of regional anesthesia (RA) have been
developed. The primary purpose of this pilot study was to compare intraoperative hemodynamic stability
and postoperative outcomes between GA and ultrasound-guided superficial cervical plexus block (UGSCPB)
under dexmedetomidine sedation for CEA.
Methods: Medical records from 43 adult patients who underwent CEA were retrospectively reviewed, including
16 in the GA group and 27 in the RA group. GA was induced with propofol and maintained with sevoflurane.
The UGSCPB was performed with ropivacaine under dexmedetomidine sedation. We compared the
intraoperative requirement for vasoactive drugs, postoperative complications, pain scores using the numerical
rating scale, and the duration of hospital stay.
Results: There was no difference between groups in the use of intraoperative antihypertensive drugs. However,
intraoperative inotropic and vasopressor agents were more frequently required in the GA group
(p<0.0001). In the GA group, pain scores were significantly higher during the first 24 h after surgery (p<
0.0001 between 0-6 h, p<0.004 between 6-12 h, and p<0.001 between 12-24 h). The duration of hospital stay
was significantly more in the GA group (13.3¡¾4.6 days in the GA group vs. 8.5¡¾2.4 days in the RA group,
p<0.001).
Conclusion: In this pilot study, intraoperative hemodynamic stability and postoperative outcomes were better
in the RA compared to the GA group.
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Key Words: Keywords: Carotid endarterectomy; Cervical plexus block; Dexmedetomidine; General anesthesia;
Ultrasonography
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