The hypothesis regarding the benefit of carotid endarterectomy under locoregional anesthesia in prevention of stroke may be unanswered.
A recent trial attempted to investigate the role of locoregional anesthesia (LA) in carotid endarterectomy (CEA) compared with general anesthesia. The hypothesis regarding the advantage of LA is based on the intraprocedural neurologic evaluation and the early identification of neurologic deficit. The trial has not demonstrated the superiority of the rocoregional anesthesia versus general anesthesia and revealed equal results concerning the prevention of stroke. We analyze the reasons which explain why the hypothesis regarding the advantage of LA in CEA, in comparison to general anesthesia cannot be answered.
Moulakakis
Konstantinos G
KG
Department of Vascular Surgery, Athens University Medical School, Attikon University Hospital, Athens, Greece. konmoulakakis@yahoo.gr
Avgerinos
Efthimios D
ED
Liapis
Christos D
CD
D000765:Anesthesia, Conduction; D000768:Anesthesia, General; D016893:Carotid Stenosis / Q000517:prevention & control / Q000601:surgery; D016894:Endarterectomy, Carotid; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D015607:Stents; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*