Key result
Regional anesthesia for CEA may improve cost-effectiveness and reduce neurologic and cardiac complications versus general anesthesia.
Why the study?
There is no consensus about the optimal type of anesthesia for carotid endarterectomy, necessitating further large-scale randomized trials.
Does regional anesthesia improve outcomes compared to general or combined anesthesia in patients undergoing carotid endarterectomy?
Does regional anesthesia improve outcomes compared to general or combined anesthesia in patients undergoing carotid endarterectomy?
While regional anesthesia for carotid endarterectomy shows potential benefits in cost and complication rates, there is currently no consensus on the optimal anesthetic approach, highlighting the need for further large-scale randomized trials.
Answers are grounded in this paper and cite their sources.
Should not yet change anesthetic practice for carotid endarterectomy; leaves open superiority of regional anesthesia pending randomized trials.
The article summarizes the international experience of using different types of anesthesia for the surgical treatment of carotid artery lesions. The anesthesiology support of surgery on the carotid basin includes general and combined anesthesia of various types. The regional anesthesia is a separate field in the carotid surgery. The paper presents the advantages and disadvantages of each anesthetic technique. The recent publications show the superiority of regional anesthesia in terms of its cost-effectiveness, less frequent use of temporary intraluminal shunt, the possibility to constant monitoring of patient’s neurological status throughout the operation, and lower incidence of neurologic and cardiac complications. Complications of the regional anesthesia and the methods of their correction are described in detail. There is still no consensus about the choice of the optimal type of anesthesia for carotid endarterectomy, hence further large-scale randomized trials are needed.
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Симонов et al. (2018) conducted a review in Carotid artery lesions. Regional anesthesia vs. General and combined anesthesia was evaluated. Regional anesthesia for carotid endarterectomy may offer advantages in cost-effectiveness and lower incidence of neurologic and cardiac complications compared to general anesthesia.
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