Key result
Local anesthesia for carotid endarterectomy yields similar rates of transient ischemic attack, stroke, myocardial infarction, and death compared with general anesthesia.
Why the study?
Does local anesthesia compared to general anesthesia improve outcomes in patients undergoing carotid endarterectomy?
Does local anesthesia compared to general anesthesia improve outcomes in patients undergoing carotid endarterectomy?
This commentary highlights that while hard clinical outcomes do not differ between local and general anesthesia for carotid endarterectomy, secondary outcomes like cognitive dysfunction, delirium, and resource utilization warrant consideration.
Like the earlier multicenter General Anesthesia (GA) versus Local Anaesthesia (LA) for carotid surgery (GALA) trial, a recent independent study showed no difference in transient ischemic attack, stroke, myocardial infarction, and death rates between carotid endarterectomy (CEA) performed under LA compared with GA. Besides these outcomes, however, several additional issues may be of interest when comparing the 2 modalities. Examples include the occurrence of post-CEA patient delirium, cognitive dysfunction, and health-related quality of life, as well as the cost-effectiveness, length of hospitalization, and resource utilization. This commentary discusses and compares these outcomes of CEA performed under LA versus GA.
No takes yet. Share an insight, caveat, or question.
Paraskevas et al. (2011) conducted a review in Carotid endarterectomy. Local anesthesia vs. General anesthesia was evaluated. Local anesthesia for carotid endarterectomy yields similar rates of transient ischemic attack, stroke, myocardial infarction, and death compared with general anesthesia.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: