The influence of anesthetic choice on carotid endarterectomy outcome
J. D. Corson, B. B. Chang, D. M. Shah, R. P. Leather, B. M. DeLeo and A. M. Karmody
This study compared the technique of general and regional cervical block
anesthesia for carotid endarterectomy. Three hundred sixty-eight patients
undergoing 399 carotid endarterectomies were administered one of these
alternative anesthetics as selected preoperatively by each patient and his
or her physician. In 242 cases general anesthesia was used. The other 157
cases were done under regional cervical block anesthesia. Perioperative
mortality was 1.0%. Nonfatal strokes occurred in 1.25%. There were
significantly more strokes in the general anesthesia group. Perioperative
blood pressure was unstable for a significantly longer period of time after
general anesthesia (mean, 24.6 hours) as compared with regional cervical
block anesthesia (mean, 2.1 hours). Furthermore, vasoactive drugs were
required for significantly longer periods of time in the general anesthesia
group.