Utilization of regional versus general anesthesia and its impact on lower extremity bypass outcomes

Journal of Vascular Surgery
Michael D SgroiMatthew W Mell

Abstract

Previous studies evaluating general anesthesia (GA) vs regional (epidural/spinal) anesthesia (RA) for infrainguinal bypass have produced conflicting results. The purpose of this study was to analyze the factors associated with contemporary use of RA and to determine whether it is associated with improved outcomes after infrainguinal bypass in patients with critical limb ischemia. Using the Vascular Quality Initiative infrainguinal database, a retrospective review identified all critical limb ischemia patients who received an infrainguinal bypass from 2011 through 2016. Patients were then separated by GA or RA. Primary outcomes were perioperative mortality, complications, and length of stay. Predictive factors for RA and perioperative outcomes were analyzed using a mixed-effects model to adjust for center differences. There were 16,052 patients identified to have a lower extremity bypass during this time frame with 572 (3.5%) receiving RA. There was a wide variation in the use of RA, with 31% of participating centers not using it at all. Age (67.2 vs 70.3 years; P < .001), chronic obstructive pulmonary disease (25.7% vs 30.9%; P < .001), and urgency of the operation (75.7% vs 80.4%; P = .01) were found to be independently associ...Continue Reading

Associated Clinical Trials

References

Dec 1, 1991·Journal of Vascular Surgery·S P RiversF J Veith
Oct 6, 1997·Journal of Vascular Surgery·R B RutherfordD N Jones
Sep 27, 2006·Journal of Vascular Surgery·Niten SinghWilliam G Henderson
Jul 28, 2009·Journal of Vascular Surgery·Glenn M LaMuragliaRichard P Cambria
Sep 5, 2012·Annals of Vascular Surgery·Racheed J GhanamiMatthew S Edwards
Dec 16, 2017·Journal of Vascular Surgery·Hanaa Dakour AridiMahmoud B Malas

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Citations

Aug 16, 2019·Current Opinion in Anaesthesiology·Alan J R MacfarlaneNabil Elkassabany
Dec 29, 2020·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·Jannie BisgaardSigne J Riddersholm
Jan 8, 2021·Anesthesiology·Phillip E Vlisides, Laurel E Moore
Feb 9, 2021·World Journal of Surgery·Mohamad El MohebHaytham M A Kaafarani
Jul 20, 2021·Journal of Vascular Surgery Cases and Innovative Techniques·Muzafar MamatkulovAnastasia Voronova

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