Superficial or deep cervical plexus block for carotid endarterectomy: a systematic review of complications. Export

@article{citeulike:3500846, abstract = {Carotid endarterectomy is commonly conducted under regional (deep, superficial, intermediate, or combined) cervical plexus block, but it is not known if complication rates differ. We conducted a systematic review of published papers to assess the complication rate associated with superficial (or intermediate) and deep (or combined deep plus superficial/intermediate). The null hypothesis was that complication rates were equal. Complications of interest were: (1) serious complications related to the placement of block, (2) incidence of conversion to general anaesthesia, and (3) serious systemic complications of the surgical-anaesthetic process. We retrieved 69 papers describing a total of 7558 deep/combined blocks and 2533 superficial/intermediate blocks. Deep/combined block was associated with a higher serious complication rate related to the injecting needle when compared with the superficial/intermediate block (odds ratio 2.13, P = 0.006). The conversion rate to general anaesthesia was also higher with deep/combined block (odds ratio 5.15, P < 0.0001), but there was an equivalent incidence of other systemic serious complications (odds ratio 1.13, P = 0.273; NS). We conclude that superficial/intermediate block is safer than any method that employs a deep injection. The higher rate of conversion to general anaesthesia with the deep/combined block may have been influenced by the higher incidence of direct complications, but may also suggest that the superficial/combined block provides better analgesia during surgery.}, author = {Pandit, J. J. and Satya-Krishna, R. and Gration, P.}, citeulike-article-id = {3500846}, citeulike-linkout-0 = {http://view.ncbi.nlm.nih.gov/pubmed/17576970}, citeulike-linkout-1 = {http://www.hubmed.org/display.cgi?uids=17576970}, issn = {0007-0912}, journal = {British journal of anaesthesia}, keywords = {carotid-endarterectomy, regional-anesthesia}, month = {August}, number = {2}, pages = {159--169}, posted-at = {2008-11-10 11:17:56}, priority = {2}, title = {Superficial or deep cervical plexus block for carotid endarterectomy: a systematic review of complications.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/17576970}, volume = {99}, year = {2007} }

TY - JOUR ID - citeulike:3500846 L3 - citeulike-article-id:3500846 N2 - Carotid endarterectomy is commonly conducted under regional (deep, superficial, intermediate, or combined) cervical plexus block, but it is not known if complication rates differ. We conducted a systematic review of published papers to assess the complication rate associated with superficial (or intermediate) and deep (or combined deep plus superficial/intermediate). The null hypothesis was that complication rates were equal. Complications of interest were: (1) serious complications related to the placement of block, (2) incidence of conversion to general anaesthesia, and (3) serious systemic complications of the surgical-anaesthetic process. We retrieved 69 papers describing a total of 7558 deep/combined blocks and 2533 superficial/intermediate blocks. Deep/combined block was associated with a higher serious complication rate related to the injecting needle when compared with the superficial/intermediate block (odds ratio 2.13, P = 0.006). The conversion rate to general anaesthesia was also higher with deep/combined block (odds ratio 5.15, P < 0.0001), but there was an equivalent incidence of other systemic serious complications (odds ratio 1.13, P = 0.273; NS). We conclude that superficial/intermediate block is safer than any method that employs a deep injection. The higher rate of conversion to general anaesthesia with the deep/combined block may have been influenced by the higher incidence of direct complications, but may also suggest that the superficial/combined block provides better analgesia during surgery. IS - 2 JF - British journal of anaesthesia SN - 0007-0912 EP - 169 TI - Superficial or deep cervical plexus block for carotid endarterectomy: a systematic review of complications. VL - 99 SP - 159 KW - carotid-endarterectomy KW - regional-anesthesia AU - Pandit, JJ AU - Satya-Krishna, R AU - Gration, P PY - 2007/08// UR - http://view.ncbi.nlm.nih.gov/pubmed/17576970 ER -