A randomised controlled trial examining the effect on the addition of the mandibular block to cervical plexus block for carotid endarterectomy

• Published in: Journal of cardiothoracic and vascular anesthesia 2018-04, Vol.32 (2), p.877-882
• Main Authors: Ozturk, Nilgun Kavrut, Kavakli, Ali Sait, Sagdic, Kadir, Inanoglu, Kerem
• Format: Article
• Language: English
• Subjects: Aged; Anesthesia & Perioperative Care; Carotid endarterectomy; cervical plexus block; Cervical Plexus Block - methods; Critical Care; Endarterectomy, Carotid - methods; Female; Humans; intraoperative VAS scores; Male; mandibular block; Mandibular Nerve; Middle Aged; Nerve Block - methods; Patient Satisfaction; Prospective Studies; Visual Analog Scale
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1053/j.jvca.2017.06.034

Objectıves Although the cervical plexus block generally provides adequate analgesia for carotid endarterectomy, pain caused by metal retractors on the inferior surface of the mandible is not prevented by the cervical block. Different pain relief methods can be performed for patients who experience discomfort in these areas. In this study, we evaluated the effect of mandibular block in addition to cervical plexus block on pain scores in carotid endarterectomy. Desıgn A prospective, randomized, controlled trial Setting Training and research hospital Participants Patients who underwent a carotid endarterectomy Interventions Patients scheduled for carotid endarterectomy under cervical plexus block were randomized into two groups: Group 1 (those who did not receive a mandibular block), Group 2 (those who received a mandibular block). The main purpose of the study was to evaluate the mandibular block in addition to cervical plexus block in terms of intraoperative pain scores. Measurements and Main Results Intraoperative Visual analog scale (VAS) scores were significantly higher in Group 1 (p=0.001). The amount of supplemental 1% lidocaine and intraoperative intravenous analgesic used were significantly higher in Group 1 (p=0.001, p=0.035, respectively). Patient satisfaction scores were significantly lower in Group 1 (p=0.044). The amount of postoperative analgesic used, time to first analgesic requirement, postoperative VAS scores, and surgeon satisfaction scores were similar in both groups. There was no significant difference between the groups in respect to complications. No major neurological deficits or perioperative mortality were observed. Conclusıons Mandibular block in addition to cervical plexus block provides better intraoperative pain control and greater patient satisfaction than cervical plexus block alone.