Carotid endarterectomy with regional anesthesia

THE SENIOR AUTHOR (REH) has changed his technique for performing carotid en darterectomy from the use of general anesthesia to the use of cervical bloc k anesthesia. Because a randomized study was not performed, it is difficult to separate effects of increased surgical experience from those caused by a change in anesthetic regimen. Nonetheless, there has been a substantial d ecrease in complications, length of hospital stay, and costs concomitant wi th the change to regional anesthesia; we think there is a causal relationsh ip (11). The use of cervical block anesthesia has practically eliminated th e non-stroke-related complications associated with carotid endarterectomy i n our practice. The technique for performing carotid endarterectomy under c ervical block anesthesia is described in detail.