Neuraxial anesthesia for infrainguinal bypass surgery may reduce short-term morbidity and length of stay compared to general anesthesia, particularly in elderly patients with respiratory problems.
Does regional or neuraxial anesthesia improve postoperative outcomes compared to general anesthesia in patients undergoing infrainguinal bypass surgery?
Neuraxial anesthesia is an effective technique for infrainguinal bypass surgery that may offer short-term benefits, particularly in elderly patients or those with respiratory comorbidities.
PURPOSE: Postoperative complications after major surgery, especially vascular procedures, are associated with a significant increase in costs and mortality. Previous studies evaluating general anesthesia versus regional or neuraxial anesthesia for infrainguinal bypass have produced conflicting results. The main aim of the present study is to review current evidence on the application of regional or general anesthesia in patients undergoing infrainguinal bypass surgery and its potential favorable effects on postoperative outcomes. CONTENTS: Patients undergoing vascular surgery often have multiple comorbidities, and it is important to outline both benefits and risks of regional anesthesia techniques. Neuraxial anesthesia in vascular surgery allows overall avoidance of general anesthesia and does provide short-term benefits beyond analgesia. Previous observational studies suggest that neuraxial anesthesia for lower limb revascularization may reduce morbidity and length of stay. However, evidence of long-term benefits is lacking in most procedures and further work is still warranted. CONCLUSIONS: Neuraxial anesthesia is usually an effective anesthesia technique for infrainguinal bypass surgery. Elderly patients and those with underlying respiratory problems may display some benefit from neuraxial anesthesia. Further evaluation within institutions should be performed to identify which patients would most benefit from regional techniques. Notably, systemic antithrombotic and anticoagulation therapy is common among this population and may affect anesthetic choices.
Schmidt et al. (Fri,) conducted a review in Infrainguinal bypass surgery. Regional or neuraxial anesthesia vs. General anesthesia was evaluated on Postoperative outcomes (morbidity and length of stay). Neuraxial anesthesia for infrainguinal bypass surgery may reduce short-term morbidity and length of stay compared to general anesthesia, particularly in elderly patients with respiratory problems.