Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
A COMPARISON OF REGIONAL AND GENERAL-ANESTHESIA IN PATIENTS UNDERGOING CAROTID ENDARTERECTOMY
Autore:
ROCKMAN CB; RILES TS; GOLD M; LAMPARELLO PJ; GIANGOLA G; ADELMAN MA; LANDIS R; IMPARATO AM;
Indirizzi:
NYU,MED CTR,DEPT SURG,DIV VASC SURG,530 1ST AVE,SUITE 6F NEW YORK NY 10016 NYU,MED CTR,DEPT SURG,DIV VASC SURG NEW YORK NY 10016 NYU,MED CTR,DEPT ANESTHESIOL NEW YORK NY 10016
Titolo Testata:
Journal of vascular surgery
fascicolo: 6, volume: 24, anno: 1996,
pagine: 946 - 953
SICI:
0741-5214(1996)24:6<946:ACORAG>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
LOCAL-ANESTHESIA; AWAKE PATIENT; SURGERY; COMPLICATIONS; STROKE; RISK;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
28
Recensione:
Indirizzi per estratti:
Citazione:
C.B. Rockman et al., "A COMPARISON OF REGIONAL AND GENERAL-ANESTHESIA IN PATIENTS UNDERGOING CAROTID ENDARTERECTOMY", Journal of vascular surgery, 24(6), 1996, pp. 946-953

Abstract

Purpose: The optimal anesthetic for use during carotid endarterectomyis controversial. Advocates of regional anesthesia suggest that it may reduce the incidence of perioperative complications in addition to decreasing operative time and hospital costs. To determine whether the anesthetic method correlated with the outcome of the operation, a retrospective review of 3975 carotid operations performed over a 32-year period was performed. Methods: The records of all patients who underwent carotid endarterectomy at our institution from 1962 to 1994 were retrospectively reviewed. Operations performed with the patient under regional anesthesia were compared with those performed with the patient under general anesthesia with respect to preoperative risk factors and perioperative complications. Results: Regional anesthesia was used in 3382 operations (85.1%). There were no significant differences in the age, gender ratio, or the rates of concomitant medical illnesses between the two patient populations. The frequency of perioperative stroke in the series was 2.2%; that of myocardial infarction, 1.7%; and that of perioperative death, 1.5%. There were no statistically significant differences in the frequency of perioperative stroke, myocardial infarction, or death on the basis of anesthetic technique. A trend toward higher frequencies of perioperative stroke (3.2% vs 2.0%) and perioperative death (2.0% vs 1.4%) in the general anesthesia group was noted. In examining operative indications, however, there was a significant increase in the percentage of patients receiving general anesthesia who had sustained preoperative strokes when compared with the regional anesthesia patients (36.1% vs 26.4%; P <0.01). There was also a statistically significant higher frequency of contralateral total occlusion in the general anesthesia group (21.8% vs 15.4%; P=0.001). The trend toward increased perioperative strokes in the general anesthesia group maybe explicable either by the above differences in the patient populations or by actual differences based on anesthetic technique that favor regional anesthesia. Conclusions: In a retrospective review of a largeseries of carotid operations, regional anesthesia was shown to be applicable to the vast majority of patients with good clinical outcome. Although the advantages over general anesthesia are perhaps small, the versatility and safety of the technique is sufficient reason for vascular surgeons to include it in their armamentarium of surgical skills. Considering that carotid endarterectomy is a procedure in which complication rates are exceedingly low, a rigidly controlled, prospective randomized trial may be required to accurately these differences.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/10/20 alle ore 13:00:14