Key result
Combined deep and superficial cervical plexus blockade for carotid endarterectomy increased systolic blood pressure (157 to 191 mm Hg) and heart rate (68 to 84 bpm).
Why the study?
Does combined deep and superficial cervical plexus blockade alter autonomic cardiovascular regulation in patients undergoing carotid endarterectomy?
Observational (n=22)
Does combined deep and superficial cervical plexus blockade alter autonomic cardiovascular regulation in patients undergoing carotid endarterectomy?
Absolute Event Rate: 191% vs 157%
Combined deep and superficial cervical plexus blockade for carotid endarterectomy impairs autonomic cardiovascular homeostasis, increasing sympathetic outflow and decreasing parasympathetic drive.
May warrant closer hemodynamic monitoring with combined cervical plexus block in carotid endarterectomy; hypothesis-generating for autonomic effects and requires randomized confirmation.
Compromised cardiac autonomic modulation can produce cardiovascular disturbances. We investigated whether combined deep and superficial cervical plexus (CP) blockade for carotid endarterectomy (CEA) produces changes in autonomic cardiovascular regulation. To estimate alterations in cardiovascular autonomic control before and after combined CP blockade in 22 patients undergoing CEA, the heart rate (HR) variability, systolic blood pressure (SBP) variability, and baroreflex sensitivity were analyzed. We found that SBP (157 +/- 28 mm Hg versus 191 +/- 38 mm Hg before and after combined CP blockade, respectively) and HR (68 +/- 10 bpm versus 84 +/- 9 bpm) increased after combined CP blockade. The high frequency power of HR variability (3.7 +/- 0.9 versus 2.2 +/- 1.2 ln/ms2) decreased (decrease in parasympathetic drive), whereas the low frequency power of SBP variability (5.5 +/- 4.7 versus 8.6 +/- 9.4 mm Hg2) increased (increase in vascular sympathetic outflow). Baroreflex sensitivity decreased, and this decrease was negatively correlated with a SBP increase (r = -0.455). The present results suggest that combined CP blockade impairs autonomic cardiovascular homeostasis and suggests an association between combined CP blockade and intraoperative or postoperative adverse cardiovascular events in high-risk cardiac patients undergoing CEA that merits further studies.
No takes yet. Share an insight, caveat, or question.
Kim et al. (2006) conducted an observational in Carotid endarterectomy (n=22). Combined deep and superficial cervical plexus blockade vs. Before blockade (baseline) was evaluated on Systolic blood pressure (SBP). Combined deep and superficial cervical plexus blockade for carotid endarterectomy increased systolic blood pressure (157 to 191 mm Hg) and heart rate (68 to 84 bpm).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: