J Neurol Surg A Cent Eur Neurosurg 2019; 80(05): 341-344
DOI: 10.1055/s-0039-1688692
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Patient Satisfaction with General versus Local Anesthesia during Carotid Endarterectomy

Jan Mracek
1   Department of Neurosurgery, Faculty of Medicine in Pilsen, Charles University, University Hospital Pilsen – Pilsen, Czech Republic
,
2   Department of Anesthesia and Intensive Care Medicine, Faculty of Medicine in Pilsen, Charles University, University Hospital Pilsen – Pilsen, Czech Republic
,
Irena Holeckova
1   Department of Neurosurgery, Faculty of Medicine in Pilsen, Charles University, University Hospital Pilsen – Pilsen, Czech Republic
,
Jiri Dostal
1   Department of Neurosurgery, Faculty of Medicine in Pilsen, Charles University, University Hospital Pilsen – Pilsen, Czech Republic
,
Jolana Mrackova
3   Department of Neurology, Faculty of Medicine in Pilsen, Charles University, University Hospital Pilsen – Pilsen, Czech Republic
,
Jan Mork
1   Department of Neurosurgery, Faculty of Medicine in Pilsen, Charles University, University Hospital Pilsen – Pilsen, Czech Republic
,
Vladimir Priban
1   Department of Neurosurgery, Faculty of Medicine in Pilsen, Charles University, University Hospital Pilsen – Pilsen, Czech Republic
› Author Affiliations
Funding This study was supported by the grant of Ministry of Health of the Czech Republic – Conceptual Development of Research Organization (Faculty Hospital in Pilsen [FNPl], 00669806).
Further Information

Publication History

20 October 2018

16 February 2019

Publication Date:
29 April 2019 (online)

Abstract

Background and Study Aims Both general and local anesthesia are used in our department for carotid endarterectomy (CEA). The decision as to which anesthetic technique to use during surgery is made individually. The aim of our study was to evaluate patient satisfaction and preference with the anesthesia type used.

Material and Methods The satisfaction of a group of 205 patients with regard to anesthesia used and their future preferences were evaluated prospectively through a questionnaire. The reasons for dissatisfaction were assessed.

Results CEA was performed under general anesthesia (GA) in 159 cases (77.6%) and under local anesthesia (LA) in 46 cases (22.4%). In the GA group, 148 patients (93.1%) were satisfied; 30 patients (65.2%) in the LA group were satisfied (p < 0.0001). The reason for dissatisfaction with GA were postoperative nausea and vomiting (7 patients), postoperative psychological alteration (3), and fear of GA (1). The reasons for dissatisfaction with LA were intraoperative pain (9 patients), intraoperative discomfort and stress (5), and intraoperative breathing problems (2). Of the GA group, 154 (96.9%) patients would prefer GA again, and of the LA group, 28 (60.9%) patients would prefer LA if operated on again (p < 0.0001). Overall, 172 patients (83.9%) would prefer GA in the future, and 33 patients (16.1%) would prefer LA.

Conclusion Overall patient satisfaction with CEA performed under both GA and LA is high. Nevertheless, in the GA group, patient satisfaction and future preference were significantly higher. Both GA and LA have advantages and disadvantages for CEA. An optimal approach is to make use of both anesthetic techniques based on their individual indications and patient preference.

 
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