Abstract

TELES, Rita  and  MANSILHA, Armando. Advantages of locoregional anesthesia in comparison to general anesthesia in carotid endarterectomy. Angiol Cir Vasc [online]. 2014, vol.10, n.2, pp.64-70. ISSN 1646-706X.

Introduction: In order to enhance the preventive surgical technique of stroke, carotid endarterectomy, several studies have been performed to clarify the anesthetic technique that relates best results with respect to morbidity, mortality, hemodynamic instability, need to use shunt, costs, cognitive function and cardiovascular outcomes. Aim: This review analyzes the published results comparing the two anesthetic techniques (locoregional and general) in carotid endarterectomy with respect to preoperative, intraoperative, and postoperative periods. Methods: A research was made initially on MEDLINE® database (http://www.ncbi.nlm.nih.gov/pubmed/) with the query “anesthesia carotid endarterectomy” applying filters for different types of articles (clinical trials, randomized clinical trials, multicentre studies, reviews, systematic reviews and meta-analysis) published in the last 10 years in english or portuguese languages. Subsequently, individual searches were made, with the same filters, for each anesthetic techniques associated with the surgical procedure under study, as well as to the different parameters to be analyzed. Results: Despite not being statistically significant, the carotid endarterectomy with locoregional anesthesia seems to predominate positively in comparison with the general anesthesia, especially in patients with carotid contralateral stenosis. The incidence of stroke, MI and death at 30 days were slightly lower, the use of shunts is considerably smaller, and the average costs associated with shorter periods of hospitalization. Conclusions: Both anesthetic techniques are safe, and should be used the one for which the surgical team is more comfortable for, optimizing cerebral blood flow, minimizing the effort and the risk of cardiac ischemia by regulating the pressure-perfusion.

Keywords : Carotid endarterectomy; General anesthesia; Regional anesthesia; Carotid stenosis; Stroke.

        · abstract in Portuguese     · text in Portuguese     · Portuguese ( pdf )