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General and Local Anesthetic Both Good for Carotid Surgery

Patients, surgeons and anesthesiologists should decide on case by case basis

MONDAY, Dec. 1 (HealthDay News) -- The outcomes of carotid surgery are similar whether the patient is under local or general anesthesia, according to a report published online Nov. 27 in The Lancet.

Steff C. Lewis, Ph.D., of Western General Hospital in Edinburgh, U.K., and colleagues in the GALA Trial Collaborative Group conducted a trial of 3,526 patients, recruited from 95 centers in 24 countries. All of the patients had symptomatic or asymptomatic carotid stenosis and while 1,753 were randomized to surgery under general anesthesia, 1,773 underwent surgery with local anesthesia.

At 30 days after surgery, 84 (4.8 percent) of the general anesthesia patients and 80 (4.5 percent) of the local anesthesia patients had a stroke, myocardial infarction or died, the researchers report. There was no difference between the two groups in terms of quality of life, length of hospital stay or primary outcome, the investigators found.

"There is no reason to prefer general over local anesthesia, or vice versa, as routine for carotid endarterectomy," the authors write. "Similarly, we showed no definite evidence that the type of anesthesia affects length of hospital stay or quality of life. Ideally, therefore, surgical and anesthetic teams should be competent in both techniques because a patient might prefer, or there might be a medical reason to choose one rather than the other."

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