Patient Satisfaction with General versus Local Anesthesia during Carotid Endarterectomy

Abstract

Background and Study Aims Both general and local anesthesia are used in our department for carotid endarterectomy (CEA). The decision as to which anesthetic technique to use during surgery is made individually. The aim of our study was to evaluate patient satisfaction and preference with the anesthesia type used. Material and Methods The satisfaction of a group of 205 patients with regard to anesthesia used and their future preferences were evaluated prospectively through a questionnaire. The reasons for dissatisfaction were assessed. Results CEA was performed under general anesthesia (GA) in 159 cases (77.6%) and under local anesthesia (LA) in 46 cases (22.4%). In the GA group, 148 patients (93.1%) were satisfied; 30 patients (65.2%) in the LA group were satisfied (p < 0.0001). The reason for dissatisfaction with GA were postoperative nausea and vomiting (7 patients), postoperative psychological alteration (3), and fear of GA (1). The reasons for dissatisfaction with LA were intraoperative pain (9 patients), intraoperative discomfort and stress (5), and intraoperative breathing problems (2). Of the GA group, 154 (96.9%) patients would prefer GA again, and of the LA group, 28 (60.9%) patients would prefer LA if operated on again (p < 0.0001). Overall, 172 patients (83.9%) would prefer GA in the future, and 33 patients (16.1%) would prefer LA. Conclusion Overall patient satisfaction with CEA performed under both GA and LA is high. Nevertheless, in the GA group, patient satisfaction and future preference were significantly higher. Both GA and LA have advantages and disadvantages for CEA. An optimal approach is to make use of both anesthetic techniques based on their individual indications and patient preference.

Ultrasound-guided intermediate cervical plexus block for postoperative analgesia in patients undergoing carotid endarterectomy under general anesthesia: a case-control study

“…In addition, it is known that the patient satisfaction is higher than regional anesthesia in patients who underwent CEA under general anesthesia. [22] Our study, in which both groups were under general anesthesia, revealed that the addition of ICPB further increased patient satisfaction. This study has some limitations.…”

“…[4] In addition, general anesthesia may be somewhat advantageous in terms of patient satisfaction. [5] On the other hand, cervical plexus blocks may provide effective postoperative analgesia and stable hemodynamics. [6] However, in almost all of these comparisons, analgesia was provided with oral and/or intravenous medications in the general anesthesia groups.…”

Effectiveness of carotid council in the treatment of carotid artery disease: Early-term outcomes of the multidisciplinary approach

“…In the comparison of general anesthesia and regional anesthesia, patients feel less pain and higher satisfaction with general anesthesia. 6 In our clinical approach, general anesthesia is our primary option for both to increase surgical comfort and patient satisfaction.…”

“…Surgery might be performed under local or general anesthesia, and arteriotomy might be repaired by patchplasty or primary sutures. [2][3][4][5][6] There is still no consensus in these practical approaches, which could change according to the specialist's experiences and available conditions.…”

Bibliographic Review Factors Influencing Patient's Anesthetic Satisfaction

“…In addition, with this theoretical review the authors showed that the factors that determine satisfaction are several and diverse and include aspects related to the patient, the anesthesiology staff, the surgery and the health institution. Another finding of this review is that various instruments are used to measure patient satisfaction with anesthesia, some of these have been widely validated 8,12,13,16,18,21-23,25,28, while others are less robust and were created only to analyze a specific case series 3,9,17,19,20,24,26. These variations could be the explanation for the notable differences between the satisfaction reports observed in this research.…”