Patient and hospital benefits of local anaesthesia for carotid endarterectomy

Objectives: this study reviews and compares carotid endarterectomy (CEA) pe rformed under local anaesthesia (LA) with CEA performed under general anaes thesia (GA) in a single institution. Methods: data were collected prospectively from 240 CEA procedures. 140GA C EA procedures are compared to 100 LA CEA procedures in terms of outcome, op erative techniques, complications, and length of stay. Results: the groups were similar for age, gender distribution and preoperat ive risk factors. There were more asymptomatic patients in the LA group. Th ere were no significant differences in death, stroke or death/stroke rate b etween the two techniques. LA CEA was associated with lower shunt rate (LA 13%, GA 50%, p<0.001), lower incidence of intraoperative hypotension (LA 8% , GA 40%, p<0.001), decreased hospital stay (median (IQ): LA 2(1-2), GA 3 ( 1-4) and a cost savings of pound 235 per CEA procedure. Conclusions: carotid endarterectomy can be performed safely under local ana esthesia with the advantage that LA CEA enables the surgeon to monitor and selectively shunt patients more accurately. In additions LA CEA is associat ed with a shorter hospital stay and important cost savings.