Page 50 - Virtual Vascular Vol 3
P. 50

Anesthetists performed the cervical plexus block under ultrasound guidance.                                     CEREBRAL FUNCTION MONITORING
                                                                                                                           The advantage of performing the carotid endarterectomy under regional block is that the
              Anatomical landmarks for the superficial cervical plexus block                                               mental status of the patient (e.g. following commands of squeezing a rubber duck,
                                                                                                                           counting 1-3, not confused) can be monitored throughout the procedure as peri-operative

                                                                  • Mastoid process                                        quality control.  Other intraoperative neurological monitoring includes
                                                                                                                           electroencephalography (EEG), cerebral oximetry, or transcranial ultrasound Doppler.
                                                                  • transverse process of

                                                                     the sixth cervical                                      Rubber duck

                                                                     vertebra


                                                                  • Posterior border of the
                                                                 Anaesthetic landmarks
                                                                     sternocleidomastoid
                                                                 for the superficial

                                                                     muscle
                                                                 cervical plexus block

                                                                  • Deep cervical plexus block, being local
                                                                     anesthesia deep to the deep cervical
                                                                     fascia and above the pre-vertebral fascia,                                                                           EEG
                                                                     can also be used














                                                                                                                                                               Cerebral oximetry


                                                                                                                                                                                                          Transcranial doppler


































        The line marks the posterior border of stenocleiodomastoid muscle, and the regional
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        block is performed under ultrasound guidance.
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