Carotid endarterectomy - A survey of UK anaesthetic practice

We conducted a postal questionnaire survey of the members of the Vascular Anaesthesia Society of Great Britain and Ireland, asking questions about the provision of anaesthesia for carotid endartectomy, Of 215 respondents, 187 were currently providing anaesthesia for carotid endarterectomy The majority of respondents (69%) always use general anaesthesia for this operation but 99/215 (46%) had some experience of regional anaesthesia for carotid endartectomy. Amongst those currently using regional anaesthesia, combined deep and superficial cervical plexus block was the technique used by 71%. Other regional techniques used included local infiltration and superficial block alone. During regional anaesthesia, most (66%) anaesthetists used cerebral monitoring techniques such as stump pressure or transcranial Doppler as well as keeping the patient awake. However, in a significant proportion of eases (37%) under general anaesthesia no cerebral monitoring was used. Reported surgical shunt insertion rates were lower in awake (mean 42%) patients than those receiving general anaesthesia (61%). Respondents using regional anaesthesia were more likely to feel that their technique was appropriate than those using general anaesthesia.