Anesthesia for lower extremity vascular bypass with peripheral nerve block

Guimarães, Jordana de Fraga; Angonese, Cristine Formighieri; Gomes, Rafael Klein; Miranda, Vasco; Farias, Carlos

doi:10.1016/j.bjane.2014.07.020

Cited by 4 publications

(3 citation statements)

References 4 publications

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“…This strategy partially mitigates the challenge of perioperative anticoagulation and anti-aggregation while ensuring adequate pain control [ 3 ]. High-quality analgesia is crucial for patient comfort and to minimize the sympathetic stress response to surgery, which causes tachycardia, hypertension, and vasoconstriction, all detrimental to the patient and graft patency [ 1 , 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…General anesthesia (GA) and regional anesthesia (RA) have both been successfully used for PVR [ 1 ]. Peripheral nerve blocks may provide an alternative to GA and regional neuraxial blocks where contraindicated as per international guidelines [ 2 , 3 ]. In our institution, when feasible, the preference is to perform procedures under spontaneous ventilation with epidural anesthesia, spinal block, or a combination of both.…”

Section: Introductionmentioning

confidence: 99%

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Alternative Postoperative Analgesia Technique for Peripheral Vascular Revascularization: A Case Report

Almeida¹,

Arantes²,

Carvalho³

et al. 2023

Cureus

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Peripheral arterial disease (PAD) patients often require surgical peripheral vascular revascularization (PVR), in which postoperative pain management can be challenging. This case report details a 43-year-old female patient with PAD who underwent urgent femoral popliteal bypass with an inverted ipsilateral great saphenous vein and left femoral endarterectomy. Due to contraindications for neuraxial anesthesia and the necessity for continuous anticoagulation, the procedure was performed under general anesthesia (GA) and an unconventional technique with intraoperative perineural catheter (PC) placement to guarantee adequate postoperative analgesia. The surgeon inserted the PC in the vicinity of the femoral nerve under direct visualization before surgical closure. Postoperative analgesia was successfully managed, demonstrating the effectiveness of this approach as part of a multimodal analgesia strategy. This case report suggests that such a technique, supervised by an anesthesiologist and supported by a multidisciplinary team, can provide effective postoperative pain control in PAD patients without interrupting perioperative anticoagulation. Formal protocols for similar procedures can arise, incorporating this analgesic option.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Alternative Postoperative Analgesia Technique for Peripheral Vascular Revascularization: A Case Report

Almeida¹,

Arantes²,

Carvalho³

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…Судинна хірургія вважається хірургією високого ризику, і більшість операцій мають ризик серцево-судинної смертності більше ніж 5 %. Пряма реконструкція оклюзії клубово-стегнового сегмента пов'язана з 2,8 % періопераційної летальності, а при позаанатомічному шунтуванні періопераційна летальність досягає 8,8 % [1,2]. Смертність зростає за наявності у пацієнтів хронічної обструктивної хвороби легень, похилого віку, захворювань серця, діабету, ниркової недостатності та вживання тютюну.…”

Section: актуальністьunclassified

The place of regional anesthesia in vascular surgery: literature review and personal experience

Masoodi,

Abramenko,

Dziuba

et al. 2023

ЕМ

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Background. Vascular surgery is a high-risk procedure, and most interventions carry a greater than 5% risk of an acute cardiac event. Direct reconstruction of aorto-iliac-femoral segment is associated with a 2.8% perioperative mortality, whereas extra-anatomic bypass has an 8.8% mortality. Arteriosclerosis obliterans is a growing public health concern affecting 8.5 million people in the United States and 200 million people worldwide. Main goals of preoperative assessment of vascular patients are risk stratification and its potential reduction by safe methods of anesthesia. Aim: to compare regional anesthesia during carotid endarterectomy, abdominal aortic aneurysm resection and repair, repair of the lower limb vessels and lower extremity amputation based on the data of the world literature and the choice of safe methods of anesthesia. Materials and methods. The materials are modern world literature, Scopus, Web of Science, MedLine, the Cochrane databases and the latest scientific research. Using the comparative method of analysis, the world literature data were compared with the experience of using regional methods of analgesia at the Kyiv Regional Clinical Hospital. Conclusions. Given the data presented in the article, it can be considered that regional anesthesia is the optimal method for use as monoanesthesia or in combination with general anesthesia in vascular surgery. The use of these methods of anesthesia by an experienced anesthesiologist can decrease length of stay in the hospital and improve the disease course in this rather complex patient population. The decision to use regional techniques should be made by the patient, surgeon, and anesthesiologist after an individualized discussion of the risk-benefit profile for each patient and type of surgery.

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The problem of choosing anesthesia method for surgical interventions on the lower limbs in young patients

Georgiyants

Popsuishapka

Ryndenko

et al. 2021

SR:MS

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The relevance of the topic is due to the prevalence of lower limbs injuries in people of working age, the complexity of the methods of their surgical treatment and the problem of finding the optimal method of anesthesia in terms of efficiency and safety. Objective of the study: to conduct a systematic analysis of modern scientific literature data on the possibility of using anesthesia methods during surgical interventions and in the case of anesthesia for injuries of the lower limbs in people of working age. Materials and methods. A search for scientific sources was carried out in the scientometric databases Scopus and Web of Science, Google Scholar, archives of journals using the keywords "general anesthesia", "regional anesthesia", "injuries of the lower limbs", "young people", "general anesthesia". The search depth was 8 years. Conclusions. The problem of choosing the method of anesthesia during traumatological surgeries in people of working age has no final solution. In general, both general and regional anesthesia can be used, despite their advantages and the possibility of complications in each case. However, in clinical practice over the past decade, general anesthesia is not always the best method of pain relief. But regional methods have less effect on the vital functions of the body, and the use of ultrasound navigation and modern local anesthetics in a minimum sufficient amount makes anesthesia conduction more effective and safe. The disadvantages of regional anesthesia can be avoided by combining it with general anesthesia. However, in the available literature, there are no recommendations on the differentiated choice of the method of anesthesia for surgical interventions on the lower limbs in people of working age and the factors that influence this

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Anesthesia for lower extremity vascular bypass with peripheral nerve block

Cited by 4 publications

References 4 publications

Alternative Postoperative Analgesia Technique for Peripheral Vascular Revascularization: A Case Report

Alternative Postoperative Analgesia Technique for Peripheral Vascular Revascularization: A Case Report

The place of regional anesthesia in vascular surgery: literature review and personal experience

The problem of choosing anesthesia method for surgical interventions on the lower limbs in young patients

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