Outcomes of Carotid Endarterectomy…

Outcomes of Carotid Endarterectomy Under General and Regional Anesthesia from the American College of Surgeons’ National Surgical Quality Improvement Program

Using the American College of Surgeons’ (ACS NSQIP) database, the authors investigate whether the type of anaesthesia (General vs Regional) independently contributes to the risk of postoperative cardiovascular complications or death. It was a retrospective analysis of prospectively maintained date for 26,070 CEAs over the period 2005 – 2009.
Postoperative stroke, MI, and death occurred in 360 (1.63%), 133 (0.6%), and 154 (0.70%) patients of the general anaesthesia group, respectively, and in 58 (1.44%), 11 (0.27%), and 27 (0.67%) patients of the regional anasthesia group, respectively. Stratification by propensity scores and adjustment for covariates demonstrated GA to be a significant risk factor for postoperative MI with an adjusted odds ratio (OR) and confidence interval (CI) of 2.18 (95% CI, 1.17-4.04), P = .01 in the entire study population. These results further validate the results from the GALA trial. The results indicate that GA for CEA is an independent risk factor for postoperative MI, particularly in patients with preoperative neurologic symptoms.
Journal of Vascular Surgery 2012;56(1):81-88

Headline: General anaesthesia for CEA is an independent risk factor for postop MI

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