Effect of anesthesia type (local or general) on neurocognitive functions in carotid endarterectomy

Aim: Neurocognitive disorders and major neurological complications can develop after carotid endarterectomy. The aim our was to investigate the effect of local or general anesthesia during carotid endarterectomy on these neurocognitive functions via objective tests. Material and Methods: The study included 30 patients who underwent carotid endarterectomy under different types of anesthesia (general anesthesia in 16 patients or local anesthesia in 14 patients) between June 2017 and August 2019. Postoperative neurocognitive functions of the patients were compared using tests to quantitatively evaluate their cognitive performance (Standardized Mini-Mental Test and Clock Drawing Test). Results: Twenty-one patients were male and nine were female. There was no serious coronary lesion, except for carotid artery stenosis. None of the patients developed major complications such as stroke or transient ischemic attack Length of stay in the intensive care unit and hospital was shorter in the local anesthesia group (p=0.005 and p=0.001). Although the preoperative Standardized Mini-Mental Test and Clock Drawing Test results of the groups were similar (p=0.765 and p=0.999). there was a significant difference in favor of the local anesthesia group in both tests in the pre-discharge period (p=0.001). Discussion: Although there is no significant difference in terms of major neurological complications, local anesthesia applications show positive results in terms of neurocognitive functions. We believe that the use of local anesthesia in carotid endarterectomy operations, to the extent allowed by other clinical features of the patient. is important for neurocognitive functions, despite surgical difficulties.