scholarly journals Prevention of Tachycardia with Atenolol Pretreatment for Carotid Endarterectomy under Cervical Plexus Blockade

1992 ◽  
Vol 20 (2) ◽  
pp. 161-164 ◽  
Author(s):  
M. J. Davies ◽  
R. H. Dysart ◽  
B. S. Silbert ◽  
D. A. Scott ◽  
R. J. Cook
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Carotid Endarterectomy ◽  
Controlled Trial ◽  
Cervical Plexus ◽  
Double Blind ◽  
Cervical Plexus Block ◽  
Randomised Controlled ◽  
Plexus Block ◽  
Atenolol Group

A double-blind, randomised, controlled trial of forty patients was carried out to determine if oral atenolol pretreatment would reduce the incidence of tachycardia during carotid endarterectomy performed under cervical plexus block. Twenty patients received a placebo and twenty patients 50 mg of atenolol two hours prior to surgery. The superficial and deep cervical blocks were performed with 1.5% lignocaine containing 1:200,000 adrenaline. The patients were monitored with the V5 lead of the electrocardiogram and intraarterial blood pressure. These measurements were recorded on a correctly calibrated paper recorder. Tachycardia (heart rate > 90 beats per minute for more than three minutes) occurred in thirteen patients in the placebo group and two patients in the atenolol group (P<0.01). There was no difference in the occurrence of bradycardia, hypotension or hypertension between the two groups. It is concluded that atenolol pretreatment is an effective method of reducing the incidence of tachycardia during carotid endarterectomy performed under cervical plexus blockade.

Comparison of Clonidine and Epinephrine in Lidocaine for Cervical Plexus Block

1997 ◽  
Vol 22 (2) ◽  
pp. 137-142
Author(s):  
Rowan R. Molnar ◽  
Michael J. Davies ◽  
David A. Scott ◽  
Brendan S. Silbert ◽  
Patricia H. Mooney
Keyword(s):  
Heart Rate ◽  
Carotid Endarterectomy ◽  
Plasma Concentrations ◽  
Prospective Trial ◽  
Onset Time ◽  
Maximum Plasma ◽  
Cervical Plexus ◽  
Double Blind ◽  
Cervical Plexus Block ◽  
Plexus Block

Background and ObjectivesCarotid endarterectomy under cervical plexus block offers the advantage of awake neurologic assessment. The hypothesis was tested that the addition of clonidine 5 μg/mL to lidocaine 1.5% for the block is as effective clinically as the addition of epinephrine 5 μg/mL but without the associated tachycardia.MethodsIn a double-blind, randomized, prospective trial of 40 patients, local anesthetic solutions of lidocaine 1.5% containing either clonidine 5 μg/mL or epinephrine 5 μg/mL were compared for cervical plexus block in patients undergoing carotid endarterectomy. Each solution was administered to 20 patients with a total lidocaine dose of 7 mg/kg. The electrocardiogram, heart rate, and arterial pressure (radial artery catheter) were continuously monitored. Blood samples were drawn for determination of serum lidocaine levels during the first hour.ResultsThe block onset time (8.4 ± 0.6 minutes for epinephrine, 8.8 ± 0.8 minutes for clonidine) and duration (139 ± 6.7 minutes for epinephrine, 148 ± 5.8 minutes for clonidine) were not different between the two groups. During the period from completion of the block until incision there was a significant heart rate increase in the epinephrine group (23% mean rise) as compared with the clonidine group (4% mean rise) (P < .003). There was no difference in blood pressure between the two groups. The maximum plasma concentrations of lidocaine were 2.5-7.6 μg/mL (mean, 4.5 ± 0.3 μg/mL) for the epinephrine group and 4.7-18.4 μg/mL (mean, 7.5 ± 0.7 μg/mL) for the clonidine group (P < .0002). The maximum concentrations were reached 0-30 minutes (mean, 8 ± 1.4 minutes) after injection for the epinephrine group and 0-10 minutes (mean, 4.5 ± 7.1 minutes) for the clonidine group (P < .03).ConclusionsClonidine 5 μg/mL is a useful additive to lidocaine 1.5% for cervical plexus block to reduce the incidence of tachycardia; however, omission of epinephrine results in higher serum lidocaine levels.

scholarly journals ANALGESIC EFFICACY OF COMBINATION OF BILATERAL SUPERFICIAL CERVICAL PLEXUS BLOCK AND STANDARD ANALGESIA WITH STANDARD ANALGESIA ALONE IN PATIENTS UNDERGOING THYROID CANCER SURGERY. A RANDOMISED-CONTROLLED TRIAL

2019 ◽  
Vol 5 (2) ◽  
Author(s):  
Hammad Nabeel Najeeb ◽  
Ahsan Waqar Khan ◽  
Athar Mukhtar Siddiqui
Keyword(s):  
Thyroid Cancer ◽  
Controlled Trial ◽  
Analgesic Efficacy ◽  
Cervical Plexus ◽  
Group A ◽  
Superficial Cervical Plexus Block ◽  
Cervical Plexus Block ◽  
Group B ◽  
Randomised Controlled ◽  
Plexus Block

Purpose: This study aimed to determine analgesic efficacy of a combination of bilateral superficial cervical plexus block (BLSCPB) and standard analgesia with standard analgesia alone in patients undergoing thyroid cancer surgery under general anaesthesia.Materials and Methods: It was a randomised-controlled trial conducted at the Anaesthesia Department of the Shaukat Khanum Memorial Cancer Hospital, Lahore. A sample size of 60 patients (30 patients in each group) was calculated with 95% confidence interval and power of 80%.Results: The mean pain-free duration for the Group A (BLSCPB group) was 72 min (SD 30.1) compared to 53 min (standard deviation 30.3) for the Group B. This shows a significant reduction in pain-free duration in Group A. Average NRS pain score in the Group A at q 0, 30, 60, 90 and 120 min was (0.83, 1.83, 0.23, 1.76 and 1.49), whereas the average pain score on NRS in the Group B at the same time interval mentioned above for Group A was (2.1, 2.73, 4.53, 2.44 and 1.85)Conclusion: Administration of BLSCPB resulted in superior analgesia after thyroid cancer surgery.Key words: Analgesia, cervical plexus block, post-operative pain, regional anaesthesia, thyroidectomy

scholarly journals Ultrasound-guided superficial cervical plexus block for analgesia in patients undergoing craniotomy via suboccipital retrosigmoid approach: study protocol of a randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034003
Author(s):  
Kun Peng ◽  
Min Zeng ◽  
Jia Dong ◽  
Xiang Yan ◽  
Dexiang Wang ◽  
...  
Keyword(s):  
Nerve Block ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Controlled Trial ◽  
Control Group ◽  
Cervical Plexus ◽  
Ethics Review ◽  
Superficial Cervical Plexus Block ◽  
Cervical Plexus Block ◽  
Plexus Block

IntroductionScalp nerve block has been proven to be an alternative choice to opioids in multimodal analgesia. However, for the infratentorial space-occupying craniotomy, especially the suboccipital retrosigmoid craniotomy, scalp nerve block is insufficient.Methods and analysisThe study is a prospective, single-centre, randomised, paralleled-group controlled trial. Patients scheduled to receive elective suboccipital retrosigmoid craniotomy will be randomly assigned to the superficial cervical plexus block group or the control group. After anaesthesia induction, superficial cervical plexus nerve block will be performed under the guidance of ultrasound. The primary outcome is the cumulative consumption of sufentanil by the patient-controlled intravenous analgesia pump within 24 hours after surgery. Secondary outcomes include the cumulative consumption of sufentanil at other four time points and numerical rating scale pain severity score.Ethics and disseminationThe protocol (version number: 2.0, 10 April 2019) has been approved by the Ethics Review Committee of China Registered Clinical Trials (Ethics Review No. ChiECRCT-20190047). The findings of this study will be disseminated in peer-reviewed journals and at scientific conferences.Trial registration numberNCT04036812

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