Carotid endarterectomy under regional anesthesia. Initial experience

Background: Endarterectomy is the treatment of choice for anesthesia has ad vantages over general anesthesia. Aim: To report our initial experience wit h carotid endarterectomy under regional anesthesia. Patients and methods: B etween 1998 and 1999, patients with critical carotid artery stenosis, asymp tomatic or with transient and recovered symptoms, were selected, A C2, C3, C4 root deep cervical block and superficial block was performed, using a mi xture of lidocaine and bupivacaine. A carotid endarterectomy with patch and without routine shunt insertion, with standard and neurological monitoring , was performed. Results: During the study period, 94 carotid endarterectom ies were done, 22 under regional anesthesia in 21 patients (12 male, age ra nge 58-90 years old). Ninety five percent had hypertension, 52% smoked and 38% had renal dysfunction. One patient was converted to general anesthesia. seventeen patients were discharged within 48 hours of the procedure and th e rest, within 72 hours. There was no mortality or complications. Conclusio ns: Endarterectomy under regional anesthesia is less invasive, has excellen t results and is well accepted by patients.