GKD Anest Yoð Bak Dern Derg. 2022; 28(2): 153-157 | DOI: 10.14744/GKDAD.2022.88156

Ultrasound-Guided Erector Spinae Plane Block for Carotid Endarterectomy: A Case Series

Ali Sait Kavaklý¹, Tayfun Sügür¹, Hayri Fatih Metinyurt¹, Arzu Karaveli¹, Burak Aksu², Kadir Saðdýç³, Umut Verkal Pekgül^1
1Department of Anesthesiology and Reanimation, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Türkiye
²Department of Cardiovascular Surgery, Private OFM Antalya Hospital, Antalya, Türkiye
³Department of Cardiovascular Surgery, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Türkiye

Objectives: Erector spinae plane (ESP) block can be used for post-operative analgesia following thoracic, abdominal, and lumbar surgeries. Furthermore, it can provide complete surgical anesthesia in some procedures at cervical or thoracic regions. The case series describes use of ESP block in 12 patients who underwent carotid endarterectomy (CEA).
Methods: Data were analyzed from 12 patients. Patient characteristics, carotid clamping time, duration of surgery, number of patients requiring intraoperative supplemental local anesthetic, amount of additional local anesthetic administered by the surgeon, opioid requirements during the surgery, time to first requirement for analgesia in intensive care unit, pain scores, post-operative analgesic consumption, and hospital stay were recorded from the patients’ medical chart.
Results: Nine of 12 patients required intraoperative supplemental 2% lidocaine. The median (interquartile range [IQR] [range]) volume of lidocaine used for supplemental infiltration was 6 (5-9 [3-12]) ml. A total of 10 (83.3%) patients requested analgesia in the first 24 h postoperatively. The median (IQR [range]) time of first analgesic requirement postoperatively was 8 (5-10.5 [1-12]) h. Mean hospital stay was 3.1±0.6 days. Conclusion: Although erector spina plane block alone cannot provide complete surgical anesthesia in CEA, it can be used as an alternative to other regional anesthesia techniques in combination with relatively low-dose local anesthetic supplementation, as well as contributing to post-operative analgesia.

Keywords: Anesthesia, carotid endarterectomy, erector spinae plane block, post-operative analgesia

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Karotis Endarterektomisi Ýçin Ultrason Rehberliðinde Erektor Spina Plan Bloku: Olgu Serisi

Ali Sait Kavaklý¹, Tayfun Sügür¹, Hayri Fatih Metinyurt¹, Arzu Karaveli¹, Burak Aksu², Kadir Saðdýç³, Umut Verkal Pekgül^1
1Saðlýk Bilimleri Üniversitesi, Antalya Eðitim ve Araþtýrma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniði, Antalya, Türkiye
²Özel Antalya OFM Hastanesi, Kalp Damar Cerrahisi, Antalya, Türkiye
³Saðlýk Bilimleri Üniversitesi, Antalya Eðitim ve Araþtýrma Hastanesi, Kardiyovasküler Cerrahi Kliniði, Antalya, Türkiye

Amaç: Erektor spina plan bloku torasik, abdominal ve lomber cerrahiler sonrasý postoperatif analjezi amacýyla kullanýlabilmektedir. Ayrýca servikal veya torasik bölgelerdeki bazý cerrahi iþlemlerde intraoperatif anestezi saðlayabileceði de bildirilmiþtir. Bu olgu serisinde, karotis endarterektomisi yapýlan hastalarda erektor spina plan bloku uygulamasý rapor edilmektedir.
Yöntem: Toplam 12 hastanýn verileri analiz edildi. Demografik veriler, karotis klemp süreleri, ameliyat süreleri, intraoperatif ek lokal anestezik gereksinimi olan hasta sayýsý, intraoperatif ek lokal anestezik miktarý, opioid gereksinimi, postoperatif ilk analjezik gereksinim zamaný, postoperatif aðrý skorlarý, postoperatif analjezik tüketimi ve hastanede kalýþ süreleri kaydedildi.
Bulgular: Verileri analiz edilen 12 hastanýn 9'unda (%75) intraoperatif ek lokal anestezik ihtiyacý oldu. Ýntraoperatif ek lokal anestezik medyan [IQR [min-max)] deðeri 6 (5-9 [3-12]) mL olarak tespit edildi. Toplam 10 (%83,3) hastada postoperatif analjezi gerekti. Postoperatif ilk analjezik gereksinimi medyan (IQR [min-max]) süresi 8 (5-10,5 [1-12]) saat olarak tespit edildi. Ortalama hastanede kalýþ süresi 3,1±0,6 gündü.
Sonuç: Karotis endarterektomisinde erektor spina plan bloku tek baþýna intraoperatif dönemde tam bir cerrahi anestezi saðlayamasa da postoperatif analjeziye katkýsýnýn yaný sýra nispeten düþük doz lokal anestezik takviyesi ile kombinasyon halinde diðer bölgesel anestezi tekniklerine bir alternatif olarak kullanýlabilir.

Anahtar Kelimeler: Anestezi, erektor spina plan bloku, karotis endarterektomisi, postoperatif analjezi

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