Document Detail

Local anesthesia for above knee femoropopliteal bypass: an alternative technique to endoluminal bypass grafting.
MedLine Citation:
PMID:  9705098     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The majority of patients with peripheral vascular disease have associated medical illnesses that contribute to a substantial incidence of perioperative complications. Some of the these complications may be related to the choice of anesthetic used. An ideal anesthetic would provide good analgesia, have few complications associated with its use, including minimizing hemodynamic instability, and provide an adequate surgical environment. MATERIALS AND METHODS: Ten patients with an occluded superficial femoral artery and claudication or rest pain were selected. Eligibility criteria were a non-obese thigh and an above knee popliteal segment of at least 10 cm. Lidocaine local anesthesia with systemic sedation was employed. Above knee femoropopliteal bypasses were performed in all patients. Intraoperative fluid volume, anesthetic dose and perioperative morbidity were recorded. RESULTS: All patients tolerated the procedure well. The operating environment was excellent. Intraoperative fluid requirements were less for patients receiving local anesthesia as compared with a similar group of patients undergoing above knee femoropopliteal bypass receiving regional anesthesia (mean 1750 ml versus 3386 ml). The mean dosage of lidocaine (0.5%) was 367 mg over a mean of 116 min operating time. All patients ambulated within 8 hours. There was no perioperative morbidity, mortality or graft occlusion. CONCLUSION: This technique is easy to perform and further reduces the systemic magnitude of anesthesia, while providing excellent perioperative analgesia and a satisfactory surgical environment. It may be ideal for the high risk patient, as intraoperative fluid volume requirements are reduced. In an era where endoluminal bypass grafting is being increasingly advocated, this technique retains the benefits of bypass grafting while possibly reducing the physiological insult.
A B Lumsden; V Weiss; M Pitts; M J MacDonald; S M Surowiec; J C Ofenloch
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiovascular surgery (London, England)     Volume:  6     ISSN:  0967-2109     ISO Abbreviation:  Cardiovasc Surg     Publication Date:  1998 Jun 
Date Detail:
Created Date:  1998-10-07     Completed Date:  1998-10-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9308765     Medline TA:  Cardiovasc Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  262-7     Citation Subset:  IM    
Division of Vascular Surgery, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
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MeSH Terms
Anastomosis, Surgical
Anesthesia, Local*
Anesthetics, Local
Arterial Occlusive Diseases / surgery*
Femoral Artery / surgery*
Popliteal Artery / surgery*
Treatment Outcome
Reg. No./Substance:
0/Anesthetics, Local; 137-58-6/Lidocaine

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