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Background and Aims Peripheral vascular disease (PVD) is a major cause of morbidity and mortality globally, with significant financial burdens on critical healthcare resources. Regional blocks is a widely used anesthesia techniques for high-risk patients with severe coexisting diseases and use of anticoagulants in which general anesthesia and neuraxial blocks is harmful and should be avoided.The aim of this study is to serve as a reminder of its significant value of regional anesthesia blocks in patients who are not appropriate for other type of anesthesia
Methods 120 patients underwent a peripheral vascular reconstruction of lower limbs which were performed under either spinal anesthesia I group (30 patients) or regional block II group (n.femoralis, n.ischiadicus, n,obturatorius)with local infiltration at the site of dissection as needed(30 patients)or combined spinal-epidural anesthesia III group (30 patients).Outcomes will include longer-term mortality;major adverse cardiovascular,pulmonary,renal and limb events;delirium;neuraxial or regional anesthesia–related complications;graft-related outcomes;length of operation and hospital stay;costs;and patient-reported or functional outcomes.
Results Operations included femoral-femoral,femoral-popliteal bypass grafting.Average age of patients 72.7 years.ASA score III-IV.The intra-operative events showed that the mean time needed to perform the block and dose of analgesics and sedatives needed during surgery was greater in group II and III,compared to group I.Local infiltration in the area on the dissection with 5 ml 1%lidocaine was required in patients in group II vs none in the spinal group and combined spinal-epidural technique.
Conclusions Lower limb vascular reconstruction can be done under regional anesthesia(n.femoralis,n.ischiadicus,n.obturatorius blocks)what can allow to avoid hard complications at patients with high-risk diseases and optimize pain relief for them.
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