Surgery of the Carotid Artery: Local Anaesthesia Versus General Anaesthesia

Kalko, Yusuf; Kafali, Eylül; Aydin, Uğur; Kafa, Ülkü; Köşker, Taylan Özgür; Başaran, Müjdat; Uğurlucan, Murat; Nargileci, Erol; Yaşar, Tekin

doi:10.1080/00015458.2007.11680011

Cited by 27 publications

(21 citation statements)

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“…However, the rate of shunt placement as well as operative time was lower in LA group than the general anesthesia group. Similarly, intensive care unit requirement, duration of hospital stay, and treatment costs were also lower in the local anesthesia group [7,8].…”

Section: Discussionmentioning

confidence: 84%

Carotid Endarterectomy: A Comparison on General and Local Anesthesia

Toktaş¹,

Goncu²,

Surer³

et al. 2015

Eur Res J

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Section: Discussionmentioning

confidence: 84%

Carotid Endarterectomy: A Comparison on General and Local Anesthesia

Toktaş¹,

Goncu²,

Surer³

et al. 2015

Eur Res J

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Section: Review Articlementioning

confidence: 81%

Carotid Endarterectomy in Awake Patient: Review Article

Erdinç¹

2019

ejcm

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Cardiac mortality and morbidity in patients undergoing carotid surgery is between 0.7% and 7.1%. Although surgical techniques used in carotid surgery varies, there are differences in anesthesia techniques and the results are different. The advantages and disadvantages of anesthesia techniques are discussed in several studies and various results have been obtained. These different results involve the acquisition or loss of anesthesia technique, even if the patient group is the same. Carotid surgery under loco/regional anaesthesia may be thought easy. Although the complex structure of the head and neck region takes difficulty of during surgery, direct cerebral monitorization in the awake patient increases the success rate of the surgery. In this review we will explain the carotid endarterectomy management in the awake patient.

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“…Literature searches of the databases identified 1294 articles. Following the screening of retrieved titles or abstracts and after assessing the full texts of relevant reports, we selected 33 articles for analysis (Fig. ).…”

Section: Resultsmentioning

confidence: 99%

Meta‐analysis and trial sequential analysis of local vs. general anaesthesia for carotid endarterectomy

et al. 2018

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Controversy exists regarding the best choice of anaesthesia for carotid endarterectomy. We aimed to evaluate the peri-operative outcomes of local vs. general anaesthesia for carotid endarterectomy. We conducted a systematic search of electronic information sources and applied a combination of free text and controlled vocabulary searches adapted to thesaurus headings, search operators and limits in each of the electronic databases. We defined peri-operative stroke, transient ischaemic attack, mortality and myocardial infarction as the primary outcome measures. We identified 12 randomised controlled trials and 21 observational studies reporting a total of 58,212 patients undergoing carotid endarterectomy under local or general anaesthesia. Analysis of observational studies demonstrated that local anaesthesia was associated with a significantly lower incidence of stroke (odds ratio (OR (95% CI) 0.66 (0.55-0.80), p < 0.0001), transient ischaemic attack (0.52 (0.38-0.70), p < 0.0001), myocardial infarction (0.55 (0.41-0.75), p = 0.0002) and mortality (0.72 (0.56-0.94), p = 0.01) compared with general anaesthesia. Analysis of randomised controlled trials did not find a significant difference in the risk of stroke (0.92 (0.67-1.28), p = 0.63), transient ischaemic attack (2.20 (0.48-10.03), p = 0.31), myocardial infarction (1.25 (0.57-2.72), p = 0.58) or mortality (0.61 (0.35-1.05), p = 0.07) between local and general anaesthesia. On trial sequential analysis of the randomised trials, the Z-curve did not cross the α-spending boundaries or futility boundaries for stroke, mortality and transient ischaemic attack, suggesting that more trials are needed to reach conclusive results. Our meta-analysis of observational studies suggests that local anaesthesia for carotid endarterectomy may be associated with lower peri-operative morbidity and mortality compared with general anaesthesia. Although randomised studies have not confirmed any advantage for local anaesthesia, this may be due to a lack of pooled statistical power in these trials.

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Surgery of the Carotid Artery: Local Anaesthesia Versus General Anaesthesia

Cited by 27 publications

References 0 publications

Carotid Endarterectomy: A Comparison on General and Local Anesthesia

Carotid Endarterectomy: A Comparison on General and Local Anesthesia

Carotid Endarterectomy in Awake Patient: Review Article

Meta‐analysis and trial sequential analysis of local vs. general anaesthesia for carotid endarterectomy

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