A Cost Analysis of Regional Versus General Anesthesia for Carotid Endarterectomy

Association of Primary Anesthesia Type with Postoperative Adverse Events After Transcarotid Artery Revascularization

“…Similarly, Siu et al demonstrated a higher median cost, longer surgical time and hospital length of stay, and greater rates of intensive care unit admission for patients who received general versus regional anesthesia after CEA. 20 Again, the authors did not speculate why morbidity and mortality were greater among the general anesthesia cohort. However, the authors showed that use of regional anesthesia was associated with discharge on postoperative day 1, which conferred a financial advantage in the regional anesthesia cohort.…”

Carotid Endarterectomy in Awake Patient: Review Article

“…Most of these injuries are transient, recovering within 6-12 months, with the recovery rate being highest in the glossopharyngeal nerve and lowest in the vagus nerve (41) . Median overall costs for GA were significantly higher than median costs for RA [medians (with interquartile ranges), $10,140 ($7,158-$12,658) versus $7,122 ($5,072-$8,511), p<0.001] (39) . A meta-analysis of 41 non-randomised studies (25,000 CEAs) reported that CEA under locoregional anaesthesia (LRA) was associated with a 40% RRR in 30-day death/ stroke, compared with CEA under general anaesthesia (GA), as well as significant reductions in myocardial infarction (MI) and respiratory complications.…”

“…Median hospital length of stay (LOS) for GA was significantly longer compared with RA (2.0 vs 1.2 days, p<0.001). Patients who received GA were also more likely to be admitted to the intensive care unit (39) . The cranial nerves (CN) can be injured during CEA by the surgical dissection, traction, electrocautery, clamp injury, or compression by a postoperative hematoma.…”

General versus local anesthesia for carotid endarterectomy: Special considerations

“…On the other hand, several authors have focused on the cost-effectiveness of general versus regional anesthesia, suggesting that regional anesthesia for CEA has been associated with shorter anesthesia and operative time and shorter length of hospital stay. [ 18 19 ]…”