[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 54.163.147.69. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Article
April 1988

Regional vs General Anesthesia

Arch Surg. 1988;123(4):523-524. doi:10.1001/archsurg.1988.01400280137030
Abstract

To the Editor.—Before accepting the conclusion of Dr Corson and colleagues1 that regional is preferable to general anesthesia for patients undergoing carotid endarterectomy, one should take a critical look at what general anesthesia encompasses, as opposed to what the authors choose to define as general anesthesia.

The authors' protocol for general anesthesia does not mention the use of preanesthetic medications; these medications, which are routinely used, can and do depress circulation and respiration—particularly so in the elderly, whose cardiovascular and respiratory systems may be compromised by emphysema and/or atherosclerosis. Next, the protocol states that endotracheal intubation was carried out in all patients and this usually entails the injection of two muscle relaxant drugs (first a nondepolarizing and then a depolarizing drug). It is also stated that all patients received nitrous oxide, which increases intrapulmonary shunting, and isoflurane, which mandates mechanical ventilatory support. At this point, muscular paralysis is

First Page Preview View Large
First page PDF preview
First page PDF preview
×