Potential advantages of local/regional or neuraxial anesthesia | Potential advantages of general anesthesia |
Shorter ICU and hospital stays | Elimination of concerns regarding anxiety, claustrophobia, discomfort, and/or ability to remain motionless and cooperate |
Avoidance of the myocardial depressant effects of general anesthetics | Elimination of concerns regarding inability to lay flat due to significant COPD, CHF, back pain, or other reasons |
Less alteration of pulmonary mechanics | Less risk of patient movement during painful stimuli (eg, during manipulation of sheaths or device delivery systems inside the iliac vessels or ischemic limb pain caused by prolonged attempts at contralateral limb cannulation) |
Less catecholamine release because of avoidance of sympathetic stimulation during laryngoscopy for endotracheal intubation and during emergence and extubation | Complete and satisfactory suspension of respiration during stent deployment |
Early detection of anaphylactic and anaphylactoid reactions because of immediate complaints of symptoms (eg, pruritus due to hives; flushing; dyspnea; wheezing due to bronchospasm; stridor; swollen lips, tongue, and uvula; syncope) | Decreased bowel peristalsis if opioids are administered in sufficient doses, which may improve the quality of intraoperative imaging |
Detection of aneurysm rupture by the patient's complaint of retroperitoneal pain | |
Decreased intraoperative blood loss with neuraxial anesthesia due to lower average MAP | |
Possible decreased in-hospital and 30-day mortality compared with general anesthesia as suggested in aggregate meta-analyses |
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