Carotid Endarterectomy under Regional (Conductive) Anesthesia

Abstract

Carotid endarterectomy is reliable in the prevention of strokes due to arteriosclerotic disease at the carotid bifurcation. Carotid endarterectomies (314) were reviewed to determine if regional anesthesia was a safe technique for carotid endarterectomy and to determine whether the neurologic complications that occurred were embolic or ischemic in origin. In patients who were neurologically intact before operation, the perioperative mortality was 0.88% and the incidence of neurologic complications was 3.1%. Observations of the awake patient suggested that half the neurologic deficits that occurred were due to embolization rather than to cerebral ischemia. The incidence of nonneurologic complications under general anesthesia was 12.9%. Under regional anesthesia, the incidence of nonneurologic complications was 2.8%. The data supports carotid endarterectomy under regional block as a safe and reliable method.