Are there factors in the disease of peroneal necrotizing fasciitis which should be used when choosing the anesthetic technique?: Descriptive analysis of a cohort from 2 centers

Abstract

BACKGROUND:This study aims to examine the factors affecting the selection of anaesthesia method in Fournier's gangrene. METHODS:A retrospective evaluation was made of 113 patients operated on because of Fournier's gangrene between January-May 2019. The operations were performed under spinal anaesthesia in 78 cases (Group S) and under general anaesthesia in 35 cases (Group G). The patients were evaluated regarding age, gender, the anaesthesia method used (spinal, general) anaesthetic agent applied, presence of sepsis, and biochemical, hematological and inflammatory parameters. RESULTS:When the patients were evaluated regarding the Fournier Gangrene Severity Index (FGSI), patients in Group S had lower scores (p=0.001). Examination of the tomography images revealed that in 13 (37.1%) patients, air values were seen in the right or left gluteal area, or both, extending to the subcutaneous tissue. In the evaluation of the factors affecting the selection of general anaesthesia, a positive correlation was determined between an increase in FGSI (r=0.482, p=0.001) and the presence of sepsis (r=0.485, p=0.001) and gluteal region involvement (r=0.628, p<0.001). CONCLUSION:The selection of anaesthesia method in Fournier gangrene patients is a complex process affected by factors, such as the patients' general condition, sepsis, and whether or not there is bleeding diathesis. The risk -benefit balance in the selection of anaesthesia method should be evaluated individually for patients.

Fascitis necrotizante de las regiones perianal, perineal y genital. Gangrena de Fournier

“…Las imágenes pueden ayudar al tratamiento, pero no deben impedir una intervención temprana, ya que el delinear la extensión de la enfermedad es una guía para el desbridamiento, así como para el planeo quirúrgico y anestésico. Boran et al 31 realizaron TC a 87 (77%) pacientes en el preoperatorio. De estos pacientes evaluados con TC, 53 (46.9%) recibieron anestesia espinal y 34 (30.1%) anestesia general.…”