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

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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. © 2012 Mosby, Inc. All rights reserved.

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Schechter, M. A., Shortell, C. K., & Scarborough, J. E. (2012). Regional versus general anesthesia for carotid endarterectomy: The American College of Surgeons National Surgical Quality Improvement Program perspective. Surgery (United States), 152(3), 309–314. https://doi.org/10.1016/j.surg.2012.05.008

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