Meta‐analysis and trial sequential analysis of local vs. general anaesthesia for carotid endarterectomy

Summary Controversy exists regarding the best choice of anaesthesia for carotid endarterectomy. We aimed to evaluate the peri‐operative outcomes of local vs. general anaesthesia for carotid endarterectomy. We conducted a systematic search of electronic information sources and applied a combination o...

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Bibliographic Details
Published in:Anaesthesia 2018-10, Vol.73 (10), p.1280-1289
Main Authors: Hajibandeh, S., Antoniou, S. A., Torella, F., Antoniou, G. A.
Format: Article
Language:English
Subjects:
Anesthesia
Boundaries
carotid endarterectomy
general anaesthesia
Heart attacks
Information sources
local anaesthesia
Local anesthesia
Meta-analysis
Morbidity
Mortality
Myocardial infarction
Neck
Randomization
Sequential analysis
Stroke
Thesauri
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Summary:Summary Controversy exists regarding the best choice of anaesthesia for carotid endarterectomy. We aimed to evaluate the peri‐operative outcomes of local vs. general anaesthesia for carotid endarterectomy. We conducted a systematic search of electronic information sources and applied a combination of free text and controlled vocabulary searches adapted to thesaurus headings, search operators and limits in each of the electronic databases. We defined peri‐operative stroke, transient ischaemic attack, mortality and myocardial infarction as the primary outcome measures. We identified 12 randomised controlled trials and 21 observational studies reporting a total of 58,212 patients undergoing carotid endarterectomy under local or general anaesthesia. Analysis of observational studies demonstrated that local anaesthesia was associated with a significantly lower incidence of stroke (odds ratio (OR (95% CI) 0.66 (0.55–0.80), p 
ISSN:0003-2409
1365-2044
DOI:10.1111/anae.14320