Dexmedetomidine during carotid endarterectomy: a registry on safety and satisfaction of patients and operators (DexTEA).

BACKGROUND From an anesthesiologic perspective, carotid endarterectomy (CEA) is an operation that is increasingly being performed with locoregional techniques and sedation. The aim of this observational study was to compare dexmedetomidine with midazolam and fentanyl during CEA in terms of perioperative adverse events, patient, anesthetist, and surgeon satisfaction, as well as the possible reduction in clamping time and the number of times additional local anesthesia is needed.

METHODS Sixty patients listed for CEA were enrolled and two types of sedation were used, both protocols widely used in our hospital, resulting in the formation of two groups of patients. Both the intermediate and superficial cervical plexus blocks were administered, and the patients in Group 1 were sedated with midazolam and fentanyl, and Group 2 was sedated with dexmedetomidine. We examined comorbidities, surgical time and clamping, and possible intraoperative use of local anesthetics and intraprocedural complications, and follow-up at 180 days to observe any residual deficits. The data were analyzed with SPSS Statistics 25 (IBM).

RESULTS Patients, anesthetists and surgeons levelled off on a high level of satisfaction (scores 3 and 4). Clamping and operation times were similar between the two groups and within the ranges described in the literature.

CONCLUSIONS There were no significant differences between the two groups regarding perioperative adverse events or decreased clamping or intervention times. Only surgeons and anesthetists were clearly aligned towards a satisfaction score of 4 with dexmedetomidine, although patients did not seem to experience any differences between the two sedations under study.