Key result
Local anesthesia for carotid endarterectomy significantly reduced mean operation time (60.2 vs 89.9 minutes) and length of hospital stay compared to general anesthesia, with no significant difference in postoperative complications.
Why the study?
Carotid endarterectomy prevents disability or fatal stroke in carotid stenosis, but whether local anesthesia is superior to general anesthesia for postoperative morbidity and mortality needed to be determined.
Does local anesthesia reduce postoperative complications, operation time, and length of hospital stay compared to general anesthesia in patients undergoing carotid endarterectomy?
RCT (n=80)
Open-label
Closed envelope method
No
Does local anesthesia reduce postoperative complications, operation time, and length of hospital stay compared to general anesthesia in patients undergoing carotid endarterectomy?
Local anesthesia for carotid endarterectomy significantly reduces operation time and hospital stay compared to general anesthesia, without increasing the risk of postoperative complications.
Answers are grounded in this paper and cite their sources.
Supports preferring local anesthesia for carotid endarterectomy to shorten procedures and stays; reinforces RCT evidence of comparable safety.
Aim: Carotid endarterectomy is performed in order to prevent disability or fatal stroke in patients with carotid stenosis. The objective of this study was to analyze and compare patients undergoing carotid endarterectomy under general or local anesthesia, and to determine whether the local anesthesia method is superior to general anesthesia in terms of postoperative morbidity and mortality. Methods: A total of 80 patients who underwent carotid endarterectomy due to significant carotid arterial stenosis under general or local anesthesia in the cardiovascular surgery clinic of our hospital between November 2016 and January 2019 were included in this prospective cohort study. Forty carotid endarterectomy operations were performed under general anesthesia and 40 under local anesthesia. The study groups were divided as the general anesthesia group and local anesthesia group. Both groups were compared in terms of sociodemographic characteristics, preoperative risk factors, postoperative complications, operation time and length of hospital stay. Results: No statistically significant difference was found between the two groups in terms of age and gender (P=0.665, P=0.636; respectively). The groups were similar in terms of the rate of asymptomatic patients, stroke or myocardial infarction, postoperative complications including minor stroke, cranial nerve damage, hematoma and internal carotid artery occlusion (P=0.264, P=0.780,P=1.000, P=0.870, P=0.870, P=1.000, P=0.723, respectively). The mean operation time and length of hospital stay were statistically significantly shorter in the local anesthesia group compared to general anesthesia group (P<0.001, P=0.655; respectively). Conclusion: Local anesthesia provided shorter operation time and length of hospital stay for carotid endarterectomy procedure. Further comprehensive prospective studies are needed to clarify benefits of the use of local anesthesia for carotid endarterectomy.
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Çayır et al. (2020) conducted an RCT in Carotid artery stenosis (n=80). Local anesthesia vs. General anesthesia was evaluated on Mean operation time (minutes) (p=<0.001). Local anesthesia for carotid endarterectomy significantly reduced mean operation time (60.2 vs 89.9 minutes) and length of hospital stay compared to general anesthesia, with no significant difference in postoperative complications.
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