Metin Onur BEYAZ, Senem URFALI, Sefer KAYA, Dilan ORUÇ, Mehmet Selim ÇÖMEZ, Sedat HAKİMOĞLU, Onur KOYUNCU, İsmet Murat MELEK, İyad FANSA

Servikal blok altında karotis endarterektomi operasyonu sonuçlarımız: Anadolu’da bir merkezde ilk uygulama

Amaç: Karotis endarterektomi operasyonu genel anestezi ile uygulanabildiği gibi, bölgesel uygulanabilen; servikal rejyonel blok, lokal-rejyonel kombine anestezi ya da lokal infiltrasyon anestezisi altında yapılabilir. Bu çalışmada rejyonel blok uygulaması ile karotis endarterektomi uygulama deneyimlerimizi sunmayı amaçlıyoruz. Yöntem: Eylül 2020- Ocak 2022 tarihleri arasında karotis arterine endarterektomi operasyonu yapılan 61 hastanın cerrahi sonrası 30 gün süreyle erken dönem sonuçları retrospektif irdelenmiştir. Hastalara ait yaş, cinsiyet, risk faktörleri, şant kullanımı, operasyon süresi, nörolojik olaylar, mortalite ve morbidite değerlendirilmiştir. Bulgular: Toplam 61 hastanın verileri retrospektif olarak incelenmiştir. Hastalardan 15’i kadın, 46’sı erkekti. Ortalama yaş 61.6±9.1 (48-88) yıl olarak hesaplandı. Semptomatik hasta sayısı 51 idi. 10 hasta asemptomatik olup stenoz derecesi %70’in üzerindeydi. 11 hastada her iki tarafa endarterektomi uygulandı. Toplam olarak 72 karotis endarterektomi operasyonu gerçekleştirildi. Ortalama işlem süresi 77.6±19.7 dakika, karotis klemp süresi 29.4±11.5 dakika olarak hesaplandı. Taburcu edilen hiçbir hastada postoperatif ilk ay içinde majör nörolojik olay, kanama, enfeksiyon ya da ölüm ile karşılaşılmadı. Sonuç: Karotis endarterektomi operasyonu artan tecrübe ile birlikte rejyonel servikal blok altında güvenle gerçekleştirilebilir.

Anahtar Kelimeler:

Karotis endarterektomi, rejyonel anestezi, inme

Our results of carotid endarterectomy under cervical block: a first application in an Anatolian medical center

Objective: Carotid endarterectomy can be performed under general anesthesia, regional cervical block, combined local-regional or local infiltration anesthesia. The aim of our research is to share our experience of patients who underwent carotid endarterectomy under regional cervical block. Methods: Between September 2020 and January 2020, a total of 61 patients who underwent carotid endarterectomy were examined retrospectively. The patients’ postoperative early results within the first 30 days were evaluated. Age, sex, risk factors, the usage of shunt, duration of the operation, neurological events, morbidity and mortality were all evaluated. Results: The data of 61 patients were analyzed retrospectively. Fifteen of the patients were female and forty-six were male. The mean age of the patients was calculated as 61.6±9.1(48-88) years. Fifty-one of the patients were symptomatic. Ten of the patients were asymptomatic, however they had a carotid stenosis of 70 percent or above. In 11 of the 61 patients, carotid endarterectomy was performed bilaterally, so a total of 72 carotid endarterectomies were performed in 61 patients. The mean duration of the procedure was 77.6±19.7 minutes, and the average time of a clamp on the carotid artery was 29.4±11.5 minutes. Major neurological events, bleeding, infections or death, were seen in none of the discharged patients within 1 month postoperatively. Conclusion: With increasing experience, carotid endarterectomy can be performed safely under regional cervical block.

Keywords:

Carotid endarterectomy, regional anesthesia, stroke,

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