Perioperative management of lower extremity revascularization

James M Anton; Marie LaPenta McHenry

doi:10.1016/j.anclin.2014.05.004

Perioperative management of lower extremity revascularization

Anesthesiol Clin. 2014 Sep;32(3):661-76. doi: 10.1016/j.anclin.2014.05.004.

Authors

James M Anton¹, Marie LaPenta McHenry²

Affiliations

¹ St. Luke's Medical Group, CHI St. Luke's Health, 6720 Bertner Avenue, Room 0520, MC 1-226, Houston, TX 77030, USA; Division of Cardiovascular Anesthesiology, Texas Heart Institute, Baylor St. Luke's Medical Center, 6720 Bertner Avenue, Room 0520, MC 1-226, Houston, TX 77030, USA. Electronic address: [email protected].
² Department of Anesthesiology, Perioperative and Pain Medicine, Stanford Hospital and Clinics, 300 Pasteur Drive, Stanford, CA 94305, USA.

PMID: 25113726
DOI: 10.1016/j.anclin.2014.05.004

Abstract

Patients presenting for lower extremity revascularization often have multiple systemic comorbidities, making them high-risk surgical candidates. Neuraxial anesthesia and general anesthesia are equivocal in their effect on perioperative cardiac morbidity and improved graft patency. Postoperative epidural analgesia may improve perioperative cardiac morbidity. Systemic antithrombotic and anticoagulation therapy is common among this patient population and may affect anesthetic techniques.

Keywords: Atherosclerosis; Cardiovascular morbidity; General anesthesia; Graft patency; Neuraxial blockade; Peripheral arterial disease; Revascularization of lower extremity.

Publication types

Review

MeSH terms

Anesthesia / methods
Humans
Lower Extremity / surgery*
Pain, Postoperative / therapy
Perioperative Care / methods*
Vascular Diseases / complications
Vascular Diseases / surgery
Vascular Surgical Procedures / methods*