Background and aims Diabetic patients undergoing below the knee amputation often represent with severe concomitant conditions. Intraoperative anaesthetic management may also have an impact on overall morbidity and morbidity. However, there still exists controversial information on the superiority of any anaesthetic technique over the other. The aim of this study was to compare the general and regional anaesthesia regarding 1-year mortality and related causative factors in diabetic patients undergoing below-the knee amputation (BKA).
Methods The files of diabetic patients undergoing below the knee amputation between 2006 and 2018 were assessed. Demographic data, anaesthesia type [general (Group GA), regional (Group RA), type of RA], haemodialysis need, duration until mortality of the patients who fulfilled the study criteria were recorded.
Results 418 patients in 583 files were included to the study. Patients in Group GA had significantly short survival duration in comparison to Group RA (55.4± 8.7 vs 91.2±10.5, days, p=0.010). Furthermore, patients in neuraxial subgroup survived significantly longer than peripheral nerve block subgroup (104.8±12.8 vs 59.4±16.8 days, p=0.027). Number of patients in Group GA and RA who died following BKA during the first year is shown in figure 1.
Conclusions According to the results of this study, neuraxial techniques provide longer survival duration in the first postoperative year in diabetic patients with severe comorbidities undergoing below the knee amputation in comparison to general anaesthesia and peripheral nerve blocks. However, such results should still be interpreted cautiously, since there may exist disguised reasons simultaneously affecting the selection of the anaesthetic technique and expected mortality rates.
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