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Surgery. 2012 Sep;152(3):309-14. doi: 10.1016/j.surg.2012.05.008. Epub 2012 Jun 27.

Regional versus general anesthesia for carotid endarterectomy: the American College of Surgeons National Surgical Quality Improvement Program perspective.

Author information

1
Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA. matthew.schechter@duke.edu

Abstract

BACKGROUND:

The ideal anesthetic technique for carotid endarterectomy remains a matter of debate. This study used the American College of Surgeons National Surgical Quality Improvement Program to evaluate the influence of anesthesia modality on outcomes after carotid endarterectomy.

METHODS:

Postoperative outcomes were compared for American College of Surgeons National Surgical Quality Improvement Program patients undergoing carotid endarterectomy between 2005 and 2009 with either general or regional anesthesia. A separate analysis was performed on a subset of patients matched on propensity for undergoing carotid endarterectomy with regional anesthesia.

RESULTS:

For the entire sample of 24,716 National Surgical Quality Improvement Program patients undergoing carotid endarterectomy and the propensity-matched cohort of 8,050 patients, there was no difference in the 30-day postoperative composite stroke/myocardial infarction/death rate based on anesthetic type. Within the matched cohort, the rate of other complications did not differ (2.8% regional vs. 3.6% general anesthesia; P = .07), but patients receiving regional anesthesia had shorter operative (99 ± 36 minutes vs 119 ± 53 minutes; P < .0001) and anesthesia times (52 ± 29 minutes vs. 64 ± 37 minutes; P < .0001) and were more likely to be discharged the next day (77.0% vs 64.4%; P < .0001).

CONCLUSION:

Anesthesia technique does not impact patient outcomes after carotid endarterectomy, but may influence overall cost of care.

PMID:
22749369
DOI:
10.1016/j.surg.2012.05.008
[Indexed for MEDLINE]
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