In the light of the recent addition of ropivacaine as a local anesthetic to our pharmacopeia, its effects at the cervical level are examined. A patient undergoing TEAC was given continuous epidural anesthesia with ropivacaine 0.5% (total dose: 167.5 mg in three hours) at C6-C7. No supplementary i.v. anesthetic was administered intraoperatively. The results obtained were compared with those of a similar case as to type of pathology and anesthetic technique, who was anesthetised with bupivacaine 0.375% (total dose: 112.5 mg in three hours-continuous epidural anesthesia) + fentanyl (0.18 mg), supplemented intravenously with ketoprophene (200 mg) + fentanyl (0.15 mg) for analgesic reasons. From this comparison, ropivacaine 0.5% was found to have greater anesthetic potential than bupivacaine 0.375%. However, it did not appear that ropivacaine exerted a protective effect on cardiovascular conditions in the course of carotid surgery. Further anesthesiologic experiences are needed to define the validity of ropivacaine in cervical surgery.
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J Vasc Surg Cases Innov Tech
April 2025
Department of Cardiovascular Surgery, Higashiosaka City Medical Center, Higashiosaka, Osaka, Japan.
A 69-year-old man with chest pain was diagnosed with acute type B aortic dissection with the entry tear located at distal arch and a distal aortic arch aneurysm. Therefore, we performed debranching thoracic endovascular aortic repair 2 weeks after type B aortic dissection onset. First, the graft was anastomosed to bilateral axillary arteries.
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December 2024
Anesthesiology and Critical Care, Faculty of Medicine, University of Banja Luka, Banja Luka, BIH.
Cervical plexus block (CPB), like other types of regional anesthesia, represents an alternative anesthetic technique in those cases where the performance of general anesthesia (GA) carries an increased risk both for the patient and the outcome of the operative treatment. It has traditionally been used for years in carotid surgery as an alternative to GA, especially due to the possibility of superior monitoring - the awake patient. However, its effectiveness has been proven in other types of neck surgery, primarily in thyroid surgery, neck dissections, tracheostomy, central venous catheter insertion, clavicle surgery, etc.
View Article and Find Full Text PDFLaryngoscope
January 2025
Department of Otolaryngology - Head and Neck Surgery, Mayo Clinic Arizona, Phoenix, Arizona, U.S.A.
We present an interesting case of a 74-year-old female who presented with spinal accessory neuropathy following an ipsilateral right-sided carotid endarterectomy 6 months after the initial injury. Subsequent surgical exploration revealed a surgical clip that had been placed directly across the spinal accessory nerve. Clip removal and neurolysis was subsequently performed, leaving the nerve intact.
View Article and Find Full Text PDFNeurology
February 2025
Department of Neurology, Department of Stroke, University Hospital Cleveland Medical Center, Case Western Reserve University, Cleveland, OH.
Background And Objectives: Although previous trials have established the efficacy and safety of endovascular thrombectomy (EVT) in large ischemic core strokes, most of them excluded patients with extracranial internal carotid artery (e-ICA) occlusion. We aimed to compare outcomes in patients with e-ICA occlusion and large ischemic core infarcts treated with EVT vs medical management (MM).
Methods: This was a secondary analysis of the SELECT2 trial, a randomized controlled trial conducted at 31 international sites.
Circulation
January 2025
Divisions of Cardiac Surgery (H.T., A.Q., R.E., R.V., M.M., J.H.C., S.V.), Li Ka Shing Knowledge Institute, St. Michael's Hospital of Unity Health Toronto, Ontario, Canada.
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