The effect of anesthesia technique in carotid endarterectomy: Regional versus general anesthesia

Results: The incidence of myocardial infarction and cerebral complications was similar between the groups (1.6% in RA group vs. 1.5% in GA group, p=1.00; 2.3% in RA group vs. 2.2% in GA group, p=1.00, respectively). The mean total operating time was significantly shorter in the RA group (92.5±7.7 min vs. 97.1±7.2 min, respectively; p<0.0001). The mean time to first postoperative analgesia requirement was significantly shorter in the GA group (193.9±20.8 min vs. 114.5±17.1 min, respectively; p<0.0001). The intraoperative hypotension rates were higher in the GA group (13.3% vs. 31.6%, respectively; p=0.0004), while the intraoperative hypertension rates were higher in the RA group (41.4% vs. 26.5%, p=0.0132). Postoperative hypotension (1.6% vs. 8.1%, respectively; p=0.0201), hypertension (26.6% vs. 69.1%, respectively; p<0.0001), and coexistence of hypotension and hypertension rates (2.3% vs. 9.6%, respectively; p=0.0185) were higher in the GA group compared to the RA group.

Conclusion: Our study results demonstrate that anesthesia techniques do not substantially affect cerebral complications, postoperative myocardial infarction, and mortality in carotid surgery. Furthermore, RA provides better hemodynamic stability, less pulmonary complications, less analgesic use, and shorter length of hospital stay.

Keywords : Carotid endarterectomy, general anesthesia, regional anesthesia