title: Cervical plexus block versus general anesthesia in carotid surgery: single center experience.
abstract: BACKGROUND
  Carotid endarterectomy may be performed under general (GA) or regional anesthesia (RA). The aim of this study was to evaluate the influence of anesthetic techniques on perioperative mortality and morbidity in patients undergoing carotid surgery.
  
  
  METHODS
  This prospective study included 1098 consecutive patients operated on between 2003 and 2009 (773 underwent cervical plexus block and 325 underwent general anesthesia).
  
  
  RESULTS
  There were 6 deaths, 3 (0.9%) after GA and 3 (0.4%) after RA (p = 0.272). Neurological complication rates were not significantly different (GA 2.1% vs. RA 1.1%, p = 0.212). Incidence of myocardial infarction was similar (GA 0.31% vs. LA 0.39%, p = 0.840). Shunt placement rate was the same in both groups, 11.1%. Total operating time and carotid clamping time were significantly shorter in RA patients (RA: 92 min vs. GA: 106 min; p < 0.001 and RA: 18 min vs. GA: 19 min; p = 0.040). There was no significant difference in number of reinterventions (RA: 1.0% vs. GA: 0.6%; p = 0.504). Pulmonary complications were common in the GA group (RA: 0 vs. GA 0.9%; p = 0.007). Time to first postoperative analgesic was significantly shorter in the GA group (RA: 226 min vs. GA: 139 min; p < 0.001).
  
  
  CONCLUSIONS
  Type of anesthesia does not affect the outcome of surgical treatment of carotid disease. However, it should be stressed that fewer respiratory complications, later requirement for first postoperative analgesic, and an awake patient who can continue oral therapy early after surgery, give priority to regional techniques of anesthesia.
authors: Center for Anesthesia, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Serbia.
authors: Dejan
authors: D
authors: Markovic
authors: Gordana
authors: G
authors: Vlajkovic
authors: Radomir
authors: R
authors: Sindjelic
authors: Dragan
authors: D
authors: Markovic
authors: Nebojsa
authors: N
authors: Ladjevic
authors: Nevena
authors: N
authors: Kalezic
keywords: carotid endarterectomy; cervical plexus block; general anesthesia