Key result
Peripheral nerve blockade safely enables infrainguinal bypass in severe HFrEF, with zero conversions to general anesthesia.
Why the study?
Severely compromised LVEF represents a major limitation for lower extremity bypass reconstruction under general or neuraxial anesthesia.
Does infrainguinal bypass under peripheral nerve block prevent anesthetic conversions and early postoperative complications in patients with chronic limb-threatening ischemia and severely compromised LVEF?
Observational (n=5)
No
Does infrainguinal bypass under peripheral nerve block prevent anesthetic conversions and early postoperative complications in patients with chronic limb-threatening ischemia and severely compromised LVEF?
Open infrainguinal reconstructions can be performed safely under peripheral nerve blockade in patients with chronic limb-threatening ischemia and severely reduced LVEF.
Answers are grounded in this paper and cite their sources.
May support peripheral nerve blockade for infrainguinal bypass in CLTI with LVEF ≤35%; hypothesis-generating and requires prospective validation.
A severely compromised left ventricular ejection fraction (LVEF) is a major limitation for lower extremity bypass reconstruction both under general anesthesia or neuraxial anesthesia (NA). A series of eight infrainguinal bypass procedures were performed under peripheral nerve block in five patients (three males and two females; median age, 67 years) with chronic limb-threatening ischemia and a preoperative LVEF of 35% or less (median, 27%; range, 20%-35%). There were no conversions to neuraxial anesthesia/general anesthesia or early postoperative complications. This study showed that open infrainguinal reconstructions can be performed safely under peripheral nerve blockade in this vulnerable category of patients.
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Mamatkulov et al. (2021) conducted an observational in Chronic limb-threatening ischemia with severely compromised left ventricular ejection fraction (n=5). Peripheral nerve block was evaluated on Conversions to neuraxial or general anesthesia and early postoperative complications.
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