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- W2140996348 abstract "The objective of this study was to assess differences in hemodynamic stability for patients undergoing carotid endarterectomy (CEA) under general anesthesia (GA) as compared with cervical block anesthesia (CBA). This is an Institutional Review Board-approved, multi-center, retrospective review of 651 patients from 1998 to 2012 undergoing CEA. A total of 254 patients undergoing CEA under CBA and 397 under GA were included. Comprehensive chart review including preoperative, postoperative, and 30-day follow-up was conducted. Hemodynamic monitoring was performed via intra-arterial catheterization of the radial artery in 98% of patients and via the brachial artery in 2%. Patients were monitored continuously intraoperatively and for 24 hours after surgery. All intraoperative vasoactive and antihypertensive medications administered were recorded. Both groups were similar in age, incidence of coronary artery disease, hypertension, and renal failure. There was a preponderance of female patients, incidence of chronic obstructive pulmonary disease, diabetes mellitus and nicotine abuse in the GA group. Evaluation of hemodynamic stability under GA vs CBA revealed that under GA patients had far more hemodynamic fluctuations, with an average of three or more fluctuations in mean arterial pressure greater than 20% (P < .001; Fig). Under GA, 51% of patients required vasopressors alone vs 36% under CBA (P < .0002). Antihypertensive medications alone were required in 63% of patients in the GA group vs 73% in the CBA group (P = .0085). Thirty percent of all patients required both vasopressors and antihypertensives during surgery; 23% (CBA) vs 34% (GA; P = .0457). There were no postoperative complications or mortality in the CBA cohort. The GA cohort developed postoperative complications (myocardial infarctions, 4; stroke, 6; hematoma, 9); however, these complications were not statistically significant compared with the CBA group. For patients undergoing CEA, CBA resulted in less hemodynamic fluctuations and fewer vasvasoactive medication requirements as compared with GA." @default.
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- W2140996348 date "2013-11-01" @default.
- W2140996348 modified "2023-10-18" @default.
- W2140996348 title "Hemodynamic Changes in Patients Undergoing Carotid Endarterectomy Under Cervical Block and General Anesthesia" @default.
- W2140996348 doi "https://doi.org/10.1016/j.jvs.2013.08.056" @default.
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