Carotid Endarterectomy Under Local Anesthesia: The Safer Alternative?

Abstract

Carotid endarterectomy can be successfully accomplished using either local or general anesthesia. The purpose of this study was to attempt to discern any differences in perioperative morbidity associated with the two anesthetic tech niques. A retrospective review was undertaken of 324 consecutive carotid en darterectomies performed by fifteen surgeons between 1979 and 1985. There were no significant differences in preoperative cardiac, pulmonary, or renal risk factors between the two anesthetic groups. Postoperative fever (p < 0.005), pulmonary complications (p < 0.05), and neurologic morbidity (p < 0.05) oc curred significantly more frequently in the general anesthesia group. The dura tion of postoperative hospitalization was shorter (p < 0.0005) in the local anes thetic cohort (3.1 ± 2.3 days) than in the general anesthetic group (5.1 ± 8.07 days). Local anesthesia for carotid endarterectomy appeared to result in less morbidity and shorter hospitalization when compared with general anesthesia. There did not appear to be any cerebral protective effect of general anesthesia during carotid endarterectomy.

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