EFFECT OF ANESTHETIC TECHNIQUE ON CARDIAC MORBIDITY FOLLOWING CAROTID-ARTERY SURGERY

PURPOSE: TO investigate the effect of anesthetic technique on cardiac morbidity after carotid artery surgery. PATIENTS AND METHODS: From 199 1 to 1994, 266 consecutive carotid endarterectomies were performed und er local/regional (n = 140) or general anesthesia (n = 126), The effec ts of anesthetic technique on postoperative adverse cardiac events wer e assessed retrospectively. RESULTS: Preoperative cardiac testing was performed in all patients undergoing general or local/regional anesthe sia, Medical characteristics were similar among patients in both group s, Forty-seven adverse cardiac events (4 myocardial infarction, 9 cong estive heart failure, 7 angina, and 27 new ventricular dysrhythmias) o ccurred postoperatively in 38 patients (14.3%), There were no deaths, The relative risks of general anesthesia for dysrhythmias, myocardial infarction, angina, congestive heart failure, and total adverse cardia c events were 2.22, 0.37, 0.83, 1.38, and 1.5, respectively. The only statistically significant differential was the increased risk of posto perative dysrhythmias after general anesthesia (P < 0.03). CONCLUSIONS : Major cardiac morbidity following carotid endarterectomy is independ ent of anesthetic technique.