Ropivacaine, versus Ropivacaine Plus Fentanyl for Carotid Endarterectomy

Abstract

Carotid disease accounts for around 30% of all strokes. Regional anesthesia may has the advantage that early diagnosis of any neurological complications during surgery, also less cardiac, stroke 50%, less operating room stay, few shunts are needed, and lower cost. Patients and Methods: After the sharing of regional anesthesia decision between patient, surgeon, and anesthesiologist, 20 patients were enrolled in this study. The patients were divided in 2 groups (n=10), group 1 (20 ml Ropivacaine 0.5% alone) and group 2 (20 ml Ropivacaine +2 μ/ml fentanyl). Following parameters were measured, onset ,duration of the block, pain score, post operative stay time, postoperative nausea, vomiting, itching and patient satisfaction. Results: Post operative stay minutes was 30.1 (2.22) in ropivacaine alone group and 13.7(3.4) in ropivacaine plus fentanyl group, P was 0.000. Post operative Nausea and vomiting 6 (30%) in Ropivacaine alone and14 (70%) in ropivacaine plus fentanyl group, P was 0.011, postoperative pain was 80% in ropivacaine group and 0% in Ropivacaine with fentanyl group, postoperative itching was 40% in ropivacaine alone and70%in fentanyl group. Patients’ satisfaction was 90% in the fentanyl plus ropivacaine group. Discussion: combination of fentanyl and Ropivacaine may be a great profit during deep cervical blockade, decreasing risk of hypertension and hyperglycemia in response to pain, so it reduces the risk of cardiac and neurological morbidity, decreasing hospital stay and cost. More studies are needed contain more number of patients with different ASA. Conclusions: Ropivacaine plus fentanyl gave more intra and post operative analgesia, and for longer duration than ropivacaine alone. The usage of ropivacaine reduces the risk of motor fibers blockade of phernic nerve, and neck muscles.