Ultrasound-guided Intermediate Cervical Block Versus Superficial Cervical Block for Carotid Endarterectomy (CERVECHO)

Centre Hospitalier Universitaire de Besancon

Status: Completed

Conditions: Carotid Atherosclerosis; Regional Anaesthesia Morbidity

Treatments: Other: landmark based superfical ropivacaine 4.75 mg/ml injection; Other: Ultrasound-guided administration of ropivacaine 4.75 mg/ml

Study type: Interventional

Funder types: Other

Identifiers

NCT01742845

P/2010/107

Details and patient eligibility

About

The aim of this prospective, randomised, controlled study is to compare the efficacy of ultrasound-guided intermediate cervical block to superficial block for carotid endarterectomy.

Patients scheduled for carotide endarterectomy under regional anaesthesia (ropivacaine 4.75 mg/ml) are randomised into 2 groups according to the technique of anaesthesia performed: superficial cervical block (Control group) or, ultrasound guided intermediate cervical block (Echo group). Main outcome is cervical block success, defined by surgery performed under regional anaesthesia without supplemental topical lidocaine. Secondary outcomes are rate of conversion to general anaesthesia, total dose of supplemental topical lidocaine and block-related complications.

Enrollment: 86 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patient scheduled for elective carotid artery endarterectomy under regional anaesthesia

Exclusion criteria

• indication for general anaesthesia
• known bleedind diathesis
• past medical allergy to local anaesthesic
• severe chronic pulmonary disease
• contralateral diaphragmatic motion abnormalities
• previous cervical ipsilateral surgery
• age < 18 years

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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86 participants in 2 patient groups

control group

Active Comparator group

Description:

landmark-based superficial cervical block is used. After insertion of the needle superficially below the skin, 20 to 30 ml of 4.75 mg/ml ropivacaine are injected fan-like in the subcutaneus plane.

Treatment:

Other: landmark based superfical ropivacaine 4.75 mg/ml injection

echo group

Experimental group

Description:

ultrasound-guided intermediate cervical block was performed. The probe is placed perpendicular to the skin, in the horizontal plane at the C3-C4 level. Needle is inserted in-plane. 10 ml ropivacaine 4.75mg/ml are injected under ultrasound control, 5 ml injected when needle is withdrawn under ultrasound control, 5 ml in the subcutaneous plane.

Treatment:

Other: Ultrasound-guided administration of ropivacaine 4.75 mg/ml