Ultrasound-Guided Intermediate Cervical Plexus Block for Transcarotid Transcatheter Aortic Valve Replacement
| Autor: | Christophe Caussin, Paola Mascitti, PierLuigi Miceli, Aurélie Veugeois, Nora Colegrave, Ivan Philip, Konstandinos Zannis |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Sedation medicine.medical_treatment 030204 cardiovascular system & hematology Transcatheter Aortic Valve Replacement 03 medical and health sciences 0302 clinical medicine Valve replacement 030202 anesthesiology medicine.artery medicine Humans Local anesthesia Prospective Studies Common carotid artery Ultrasonography Interventional Cervical Plexus Block business.industry Aortic Valve Stenosis Perioperative Surgery Treatment Outcome Anesthesiology and Pain Medicine Aortic Valve Anesthetic France medicine.symptom Cardiology and Cardiovascular Medicine Complication business medicine.drug |
| Zdroj: | Journal of Cardiothoracic and Vascular Anesthesia. 35:1747-1750 |
| ISSN: | 1053-0770 |
| DOI: | 10.1053/j.jvca.2020.08.053 |
| Popis: | Objective To report the authors’ initial experience of transcarotid transcatheter aortic valve replacement (TAVR) managed with ultrasound-guided intermediate cervical plexus block. Design A single-center prospective study. Setting A teaching hospital in Paris, France. Participants All consecutive patients undergoing a transcarotid TAVR were included. Interventions The ultrasound-guided intermediate cervical plexus block was performed in 28 of 31 patients. In 3 patients, the procedure was scheduled under general anesthesia: 2 because of failure of previous transfemoral procedures under local anesthesia, and 1 for an emergency procedure in a pulmonary edema context. Measurements and Main Results Anesthesia and all perioperative parameters were recorded, as well as any complications after the procedure. Twenty-eight patients were managed with intermediate cervical plexus block and light sedation without any anesthesia-related complication. No conversion to general anesthesia was required. The use of vasopressor was only required in 11% of the patients. In 2 patients, a loss of consciousness after the common carotid artery cross-clamping test occurred, leading to the use of a temporary femoral-carotid shunt; no other change in consciousness was recorded during the procedure. Conclusions Ultrasound-guided intermediate cervical plexus block appeared to be an alternative anesthetic technique for carotid TAVR, providing adequate surgical conditions, continuous neurologic monitoring, and arterial pressure stability. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect