Hajibandeh S, et al. - Researchers compared local anaesthesia to general anaesthesia for carotid endarterectomy by comparing the peri-operative outcomes for both approaches. They systematically searched electronic information sources and applied a combination of free text and controlled vocabulary searches adapted to thesaurus headings, search operators and limits in each of the electronic databases. They analyzed 12 randomised controlled trials and 21 observational studies including a total of 58,212 patients. They carried out trial sequential analysis of the randomised trials. Local anaesthesia vs general anaesthesia for carotid endarterectomy may be associated with lower peri-operative morbidity and mortality, as indicated in observational studies. Randomised studies, possibly due to a lack of pooled statistical power, have not corroborated any advantage for local anaesthesia.