General Anesthesia Versus Local Anesthesia for Carotid Surgery (GALA)
Summary by Tarek Elshazly MD, 02.28.22
https://pubmed.ncbi.nlm.nih.gov/19041130/
Take Home Point:
--> It is a multicenter randomized controlled trial that compared outcomes of CEA under GA (n=1753) vs LA (n=1773) in 3526 patients (95 centers, 24 countries).
--> Of note, most patients undergoing local anesthesia received a cervical-plexus block (1532 [93%]..
--> Primary outcome = proportion of patients with stroke (including retinal infarction), myocardial infarction, or death between randomization and 30 days after anesthesia.
--> Time to first stroke, MI, or death at 1 year did not differ significantly between the two groups
Conclusion: "In regard to major perioperative complications of stroke, myocardial infarction, and death, there is no reason to prefer general over local anaesthesia, or vice versa, as routine for carotid endarterectomy. Similarly, we showed no definite evidence that the type of anaesthesia affects length of hospital stay or quality of life. Ideally, therefore, surgical and anaesthetic teams should be competent in both techniques because a patient might prefer, or there might be a medical reason to choose one rather than the other."
Additional Reading: