Trial reportWorld journal of surgery2009
Impact of general versus local anesthesia on early postoperative cognitive dysfunction following carotid endarterectomy: GALA Study Subgroup Analysis.
Trial report in World journal of surgery, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- Local versus general anaesthesia for carotid endarterectomy.The Cochrane database of systematic reviews · 2021Pooled it
- Dexmedetomidine improves cognition after carotid endarterectomy by inhibiting cerebral inflammation and enhancing brain-derived neurotrophic factor expression.The Journal of international medical research · 2019Trial
- Sevoflurane-induced hemispheric cerebral blood flow reduction in mice with revived global perfusion after carotid artery occlusion.European journal of medical research · 2026Article
- Analysis of risk factors for postoperative delirium in middle-aged and elderly fracture patients in the perioperative period.Scientific reports · 2023Article
- Postoperative Delirium and Cognitive Dysfunction after General and Regional Anesthesia: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2023Review
- Impact of inhalational anesthetics on postoperative cognitive function: Study protocol of a systematic review and meta-analysis.Medicine · 2018Article
- [Regional anesthesia for carotid surgery : An overview of anatomy, techniques and their clinical relevance].Der Anaesthesist · 2017Review
- Beneficial effects of intravenous dexmedetomidine on cognitive function and cerebral injury following a carotid endarterectomy.Experimental and therapeutic medicine · 2016Article
- Reduced middle cerebral artery velocity during cross-clamp predicts cognitive dysfunction after carotid endarterectomy.Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2014Observational
- Research studies that have influenced practice of neuroanesthesiology in recent years: A literature review.Indian journal of anaesthesia · 2013Article
- Age-dependent effects of carotid endarterectomy or stenting on cognitive performance.Journal of neurology · 2012Article
- Interaction of cerebrovascular disease and contralateral carotid occlusion in prediction of shunt insertion during carotid endarterectomy.Archives of medical science : AMS · 2012Article
- General anaesthesia does not contribute to long-term post-operative cognitive dysfunction in adults: A meta-analysis.Indian journal of anaesthesia · 2011Article
- Protamine reduces bleeding complications associated with carotid endarterectomy without increasing the risk of stroke.Journal of vascular surgery · 2010Article
- General versus local anesthesia for carotid endarterectomy: Special considerations.Saudi journal of anaesthesiaReview
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of this study was to compare the influence of either general (GA) or local (LA) anesthesia on the postoperative neurocognitive outcome in patients undergoing carotid endarterectomy (CEA) in a randomized study. Therefore, we performed a subgroup analysis of the multicenter GALA study.
methodsA total of 40 patients were enrolled and randomized to receive either LA (n = 17) or GA (n = 23) anesthesia. The indication for intraoperative shunting was based on the intraoperative cognitive performance in the LA group and on the clinical experience of the surgeon in the GA group. Outcome measurements included patient performance on a neuropsychological Trail Making Test, evaluation of patients mood using the self-report inventory BSKE, and serum levels of the neurobiochemical marker S100beta. The data were analyzed for each variable using a t-test and were presented as the mean (SD). Differences in shunt frequency were analyzed performing a chi-squared test. Group differences in the Trail Making Test, BSKE evaluation, and S100beta concentrations were derived from the analyses of covariances with repeated measurements using preoperative values as covariates.
resultsCompared to baseline, the S100beta concentrations increased significantly in the GA group [0.086 (0.038) vs. 0.061 (0.024) microg/l; p < 0.001] before unclamping of the carotid artery, whereas there were no changes in the LA group [0.068 (0.024) microg/l, p = 0.09 vs. 0.061 (0.021) microg/l, p = 0.09). Furthermore, we detected significant group differences after surgical intervention (GA 0.087 (0.031) microg/l; LA 0.06 (0.021) microg/l; p = 0.006). The postoperative neurocognitive performance in the Trail Making Test decreased significantly in the GA group, whereas there were no significant changes in the LA group. The self-report inventory BSKE evaluation revealed no significant group differences.
conclusionsWe concluded that performing local anesthesia in patients undergoing CEA positively influenced early postoperative neurocognitive outcomes. Significant group differences in postoperative S100beta concentrations confirmed the beneficial effect of local anesthesia.
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