Preoperative carotid sinus block prevents the low hemodynamic state in the perioperative period of carotid artery stenting

Objective To evaluate carotid sinus block (CAS) in preventing the low hemodynamic state in the perioperative period of carotid artery stenting (CAS). Method A prospective single-center randomized controlled study was conducted on 172 patients with internal carotid artery stenosis receiving CAS from May 2015 to May 2018. Patients were randomly divided into group A treated with local anesthesia of the carotid artery sinus of the trouble side under the guidance of ultrasound preoperatively and group B without local block anesthesia.The carotid artery stenosis rate, the maximum intraoperative reduction of blood pressure and heart rate, the use of atropine and vasopressor were monitored and compared between the two groups. Results There were no significant differences between the two groups in preoperative general data, degree of stenosis, plaque nature, degree of residual stenosis (P>0.05). The maximum reduction of intraoperative blood pressure and heart rate in group A was significantly lower than that in group B, and the number and dose of intraoperative atropine were smaller than those in group B (P<0.05). The number of postoperative patients with low hemodynamic status in group A and the time period of vasopressor use were significantly less than those in group B (P<0.05). Conclusion Preoperative carotid sinus block anesthesia is safe and effective in preventing low hemodynamic status in perioperative period of CAS.