Epidural versus general anesthesia for infrainguinal arterial reconstruction

S. P. Rivers, Larry A. Scher, E. Sheehan, F. J. Veith

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

A prospective evaluation of 213 consecutive infrainguinal bypass procedures was performed to determine the effect of anesthesia technique on the postoperative complication rate. Limb salvage was the indication for surgery in 92% of cases. No significant differences were observed in age, sex, indication for surgery, presence of cardiovascular and pulmonary risk factors, American Society of Anesthesiologists classification, or Goldman scores between patients receiving epidural anesthesia and those receiving general endotracheal anesthesia. Epidural anesthesia was used for 96 procedures and general endotracheal anesthesia was used in 117 cases. Cardiac complications for the epidural anesthesia and general endotracheal anesthesia groups, respectively, included a mortality rate of 5% versus 3%, nonfatal infarctions in 6% versus 7%, and reversible cardiac events in 14% versus 16%. A high-risk subgroup of 69 patients (American Surgical Association classes IV and V or Goldman score > 10 points) also had no significant difference in outcome between epidural anesthesia and general endotracheal anesthesia. Major noncardiac complications occurred in an additional 8% of each group. Regional and general anesthesia therefore produce equivalent cardiovascular risk for infrainguinal arterial reconstruction. These results suggest that indicated operations should not be postponed or avoided for patients either requiring or requesting general anesthesia. Furthermore, other investigations of cardiac risk in vascular surgery do not require a uniform anesthetic technique for valid interpretation of results.

Original languageEnglish (US)
Pages (from-to)764-770
Number of pages7
JournalJournal of Vascular Surgery
Volume14
Issue number6
DOIs
StatePublished - 1991

Fingerprint

Endotracheal Anesthesia
General Anesthesia
Epidural Anesthesia
Limb Salvage
Conduction Anesthesia
Infarction
Blood Vessels
Anesthetics
Anesthesia
Lung
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Epidural versus general anesthesia for infrainguinal arterial reconstruction. / Rivers, S. P.; Scher, Larry A.; Sheehan, E.; Veith, F. J.

In: Journal of Vascular Surgery, Vol. 14, No. 6, 1991, p. 764-770.

Research output: Contribution to journalArticle

Rivers, S. P. ; Scher, Larry A. ; Sheehan, E. ; Veith, F. J. / Epidural versus general anesthesia for infrainguinal arterial reconstruction. In: Journal of Vascular Surgery. 1991 ; Vol. 14, No. 6. pp. 764-770.
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