Document Detail


Anesthesia type does not influence early graft patency or limb salvage rates of lower extremity arterial bypass.
MedLine Citation:
PMID:  9052557     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The effect of anesthesia type on 30-day graft patency and limb salvage rates was evaluated in patients who underwent femoral to distal artery bypass.
METHODS: Of 423 patients randomly assigned to receive general, spinal, or epidural anesthetic, 76 did not meet protocol standards and 32 had inadequate anesthesia. A chart review of the remaining 315 patients was undertaken to obtain surgical information not recorded in the original study. All patients were monitored with radial and pulmonary artery catheters. After surgery, patients were in a monitored setting for 48 to 72 hours and had graft function assessments hourly during the first 24 hours and then every 8 hours until discharge.
RESULTS: Fifty-one patients were lost to follow-up (15 general, 22 spinal, 14 epidural). Baseline clinical characteristics were similar for the three groups except prior carotid artery surgery, which was more common in the spinal group. Indications for surgery were also similar except for a higher incidence of nonhealing ulcer in the epidural group. There were no differences among groups for 30-day graft patency with or without reoperation, 30-day graft occlusion, death, amputation, or length of hospital stay.
CONCLUSION: These results suggest that the type of anesthetic given for femoral to distal artery bypass does not significantly affect 30-day occlusion rate, limb salvage rate, or hospital length of stay.
Authors:
E T Pierce; F B Pomposelli; G D Stanley; K P Lewis; J L Cass; F W LoGerfo; G W Gibbons; D R Campbell; D V Freeman; E F Halpern; R H Bode
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  25     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  1997 Feb 
Date Detail:
Created Date:  1997-03-26     Completed Date:  1997-03-26     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  226-32; discussion 232-3     Citation Subset:  IM    
Affiliation:
Department of Anesthesia, Beth Israel Deaconess Medical Center, Boston, MA, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Amputation*
Anesthesia*
Anesthesia, Epidural
Anesthesia, General
Anesthesia, Spinal
Arm / blood supply
Female
Femoral Artery / surgery*
Graft Occlusion, Vascular* / diagnosis
Humans
Intermittent Claudication / surgery
Leg / blood supply*,  surgery
Leg Ulcer / surgery
Length of Stay
Male
Reoperation
Saphenous Vein / transplantation
Treatment Outcome
Vascular Patency*
Veins / transplantation*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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