Place of the Echoguide cervical block in carotid endarterectomy

Carotid endarterectomy is a well-established procedure for the secondary prevention of stroke. While general anaesthesia (GA) has traditionally been the standard approach, ultrasound-guided locoregional anaesthesia (LRA) has gained popularity due to advantages such as improved haemodynamic stability and real-time neurological monitoring. In our series, ultrasound-guided cervical plexus block was systematically employed, providing satisfactory anaesthetic comfort without the need for conversion to GA. These findings are consistent with existing literature, including the GALA trial, which highlighted the importance of individualised anaesthetic choice.

 Ultrasound guidance enhances the safety and precision of cervical blocks by enabling direct visualisation of anatomical structures and optimising anaesthetic diffusion.

 In our experience, the block was performed in an average of 10 minutes, with high surgeon satisfaction. Complications were rare and minor .Postoperative analgesia was generally effective with minimal opioid use. 

Despite the study’s limitations, our results support ultrasound-guided LRA as a safe and effective alternative to GA in carotid endarterectomy.