Effect of fentanyl addition to bupivacaine on cervical plexus block for carotid endarterectomy pp. 319-323
Authors: Walter P. Neto, Adriana M. Issy, and Rioko K. Sakata
Abstract: Cervical plexus block can be used for carotid endarterectomy since it permits immediate neurological assessment. Fentanyl is frequently used for different techniques of regional analgesia. The objective of this study was to evaluate the intra and postoperative analgesic effect of fentanyl addition to bupivacaine for cervical plexus block. Methods: Thirty patients were randomly allocated into two groups in a double-blind design: G1 received 100 μg fentanyl (2 ml) associated to 1.5 mg.kg-1 of 0.375% bupivacaine, and G2 received saline (2 ml) associated to 1.5 mg.kg-1 of 0.375% bupivacaine. The following parameters were analyzed: intraoperative anesthetic supplementation; first analgesic request; total dose of analgesic used; and postoperative pain intensity at times 0, 30, 60, 120, 240 and 360 min after surgery. Results: The mean amount of supplemental lidocaine was 2.4 ml in G1 and 3.6 ml in G2, with no significant difference between groups (p= 0.3942, Mann-Whitney test). The time between plexus block and first supplementation was 299.0 69.1 min in G1 and 265.0 ± 130.3 min in G2, with nonsignificant difference (p= 0.7758, Mann-Whitney test). There was no difference in the dipyrone (p= 0.2181) or tramadol dose used (p= 1.0000, Fisher‘s exact test). No difference in pain intensity was observed between groups. Conclusion: The addition of 100 μg fentanyl to bupivacaine 0.375% for cervical plexus block in carotid endarterectomy did not promote an improvement in the analgesic effect.