Carotid endarterectomy: A comparison of regional versus general anesthesiain 500 operations

The outcomes of 489 patients undergoing 500 carotid endarterectomies were r eviewed to compare results from using general anesthesia with those from us ing regional (cervical block) anesthesia. From September 1982 to May 1998, 228 procedures (221 patients) were performed under general anesthesia and 2 72 procedures (268 patients) were performed under local anesthesia. A detai led comparison of the two groups revealed close similarity in age, sex, pre senting symptoms, and associated risk factors. Overall, perioperative morta lity was 0.8%. In comparison to regional anesthesia, the general anesthesia group had greater overall morbidity (23.3 vs. 13.6%, p < 0.008) and more f requent use of postoperative vasoactive drugs to control blood pressure (40 .4 vs. 26.1%, p < 0.001). Furthermore, anesthesia time, operative time, and frequency of shunt use were significantly greater in the general anesthesi a group (p < 0.03). DOI: 10.1007/s100169910026.