In Reply.—In today's era of informed consent, it would be dangerous and somewhat cavalier to define general anesthesia as a "polypharmacologic assault on the unsuspecting." The wide range of available anesthetic agents and techniques allows skilled anesthesiologists ample leeway in tailoring their expertise for the benefit of the individual patient and surgeon. We certainly did not mean to imply from our data that there is only one way to "skin a cat" or give general anesthesia.
The main advantage of regional block anesthesia is the ability to communicate with the patient during the procedure and directly monitor cerebral function.
Our technique with regional block anesthesia gave superior results compared with our defined general anesthesia technique. Our data support the conclusion that regional block anesthesia is a safe technique for the performance of carotid endarterectomy and suggests that it may be preferable to the use of general anesthesia for carotid