Effect of anesthetic technique on cardiac morbidity following carotid artery surgeryEffect of anesthetic technique on cardiac morbidity following carotid artery surgery

Purpose To investigate the effect of anesthetic technique on cardiac morbidity after carotid artery surgery. Patients and methods From 1991 to 1994, 266 consecutive carotid endarterectomies were performed under local/regional (n = 140) or general anesthesia (n = 126). The effects of anesthetic technique on postoperative adverse cardiac events were assessed retrospectively. Results Preoperative cardiac testing was performed in all patients undergoing general or local/regional anesthesia. Medical characteristics were similar among patients in both groups. Forty-seven adverse cardiac events (4 myocardial infarction, 9 congestive heart failure, 7 angina, and 27 new ventricular dysrhythmias) occurred postoperatively in 38 patients (14.3%). There were no deaths. The relative risks of general anesthesia for dysrhythmias, myocardial infarction, angina, congestive heart failure, and total adverse cardiac events were 2.22, 0.37, 0.83, 1.38, and 1.5, respectively. The only statistically significant differential was the increased risk of postoperative dysrhythmias after general anesthesia (P<0.03). Conclusions Major cardiac morbidity following carotid endarterectomy is independent of anesthetic technique.