What is the clinical evidence from this study?

Study design: Cohort. Population: Carotid artery stenosis (n=205). Intervention: General anesthesia vs. Regional anesthesia. Primary outcome: Composite adverse event (postoperative morbidity [stroke and/or myocardial infarction] and/or mortality within 30 days) (OR 1.30, 95% CI 0.57-2.97, p=0.531).

What question did this study set out to answer?

To evaluate and compare the impact of general anesthesia versus regional anesthesia on 30-day perioperative morbidity and mortality in patients undergoing elective carotid endarterectomy.

March 21, 2026Acibadem Universitesi Saglik Bilimleri DergisiOpen Access

Comparison of General and Regional Anesthesia in Carotid Endarterectomy: A Retrospective Cohort Study

Q: What does this research mean for the field?

General anesthesia results in comparable 30-day composite adverse event rates compared to regional anesthesia in patients undergoing elective carotid endarterectomy. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

General anesthesia is associated with similar 30-day major events versus regional anesthesia in elective carotid endarterectomy.

OR 1.30
95% CI 0.57-2.97
P=0.531
n=205

Why the study?

The relative impact of general anesthesia versus regional anesthesia on perioperative outcomes during carotid endarterectomy remains debated in routine clinical practice.

Does general anesthesia compared to regional anesthesia reduce composite adverse events in adult patients undergoing elective carotid endarterectomy?

Key Points

To evaluate and compare the impact of general anesthesia versus regional anesthesia on 30-day perioperative morbidity and mortality in patients undergoing elective carotid endarterectomy.
Single-center retrospective cohort study analyzing 205 adult patients who underwent elective carotid endarterectomy between January 2021 and December 2023.
Patients were categorized by anesthetic approach into general anesthesia (n=130) and regional anesthesia (n=75) cohorts.
The primary outcome was a composite 30-day adverse event defined as postoperative morbidity (stroke and/or myocardial infarction) and/or mortality, evaluated via multivariable logistic regression.
Composite adverse events occurred in 14.6% (19/130) of patients receiving general anesthesia and 17.6% (13/75) receiving regional anesthesia (p=0.606).
Multivariable logistic regression demonstrated that general anesthesia was not an independent predictor of adverse events compared to regional anesthesia (OR 1.30; 95% CI 0.57–2.97; p=0.531).
Individual 30-day morbidity (14.6% vs. 18.7%; p=0.447) and mortality rates (0.8% vs. 2.6%; p=0.303) showed no statistically significant differences between the two anesthetic techniques.

Study Design

Type

Cohort (n=205)

Multicenter

Structured PICO

Does general anesthesia compared to regional anesthesia reduce composite adverse events in adult patients undergoing elective carotid endarterectomy?

Population

Adult patients who underwent elective carotid endarterectomy (CEA)

Intervention

General anesthesia (GA)

Comparator

Regional anesthesia (RA)

Outcome

Composite adverse event defined as postoperative morbidity (stroke and/or myocardial infarction) and/or mortality within 30 dayscomposite

Main Result

Effect estimate: OR 1.30 (95% CI 0.57-2.97)

Absolute Event Rate: 14.6% vs 17.6%

p-value: p=0.531

General and regional anesthesia are associated with comparable perioperative outcomes following carotid endarterectomy, suggesting that patient-related risk factors influence outcomes more than the anesthesia technique itself.

Limitations

Retrospective and single-center design
Lack of randomization leading to potential selection bias
Non-standardized sedation practices in the regional anesthesia group
Low incidence of postoperative adverse events limiting statistical power
Absence of standardized intraoperative cerebral perfusion monitoring
Absence of long-term neurovascular outcome assessment
Single-center retrospective cohort study
Relatively low incidence of adverse events limiting statistical power
Sedation protocols, agent selection, and dosing were not standardized

Discussion

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Implication

Prioritizes patient risk factors over anesthesia choice in elective CEA; reinforces consensus on comparable GA and regional outcomes.

Cite This Study

Güler et al. (2026) conducted a cohort in Carotid artery stenosis (n=205). General anesthesia vs. Regional anesthesia was evaluated on Composite adverse event (postoperative morbidity [stroke and/or myocardial infarction] and/or mortality within 30 days) (OR 1.30, 95% CI 0.57-2.97, p=0.531). General anesthesia resulted in comparable 30-day composite adverse event rates compared to regional anesthesia in patients undergoing elective carotid endarterectomy (14.6% vs 17.6%, OR 1.30).

synapsesocial.com/papers/69be386a6e48c4981c678dbc https://doi.org/10.31067/acusaglik.1846162

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Comparison of General and Regional Anesthesia in Carotid Endarterectomy: A Retrospective Cohort Study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Comparison of General and Regional Anesthesia in Carotid Endarterectomy: A Retrospective Cohort Study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider