Document Detail


The effect of epidural anaesthesia on peripheral resistance and graft flow following femorodistal reconstruction.
MedLine Citation:
PMID:  7664020     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the extent to which epidural anaesthesia influences peripheral resistance and graft blood flow following femorocrural reconstruction. DESIGN: Prospective, controlled study measuring blood flow, arterial pressure and peripheral resistance in femorocrural bypass grafts for 20 min following onset of epidural anaesthesia with 15ml of 0.25% bupivacaine. PATIENTS: Twenty patients undergoing femorocrural reconstruction for critical lower-limb ischaemia with in situ long saphenous vein, under general anaesthesia. Ten patients had epidural cannulae inserted preoperatively and injected with bupivacaine after completion of the graft. RESULTS: Peripheral resistance fell in all 10 patients receiving epidural anaesthesia from a mean (range) of 1.07 PRU (0.32-2.2) to 0.49 PRU (0.19-0.72), compared to control values of 0.95 PRU (0.39-2.0) to 0.91 PRU (0.41-1.51; P < 0.01, Wilcoxon). There was a tendency for blood pressure to fall in the study patients (not significant) but graft blood flow still increased from 98 ml min-1 (41-221) to 160 ml min-1 (101-250), compared to flow in the control patients of 101 ml min-1 (45-176) at baseline to 104 ml min-1 (56-168; p < 0.01) at 20 min. CONCLUSIONS: Epidural anaesthesia significantly decreases peripheral resistance and increases graft blood flow in femorocrural grafts and would appear, therefore, to be of benefit for patients undergoing femorodistal reconstruction.
Authors:
N C Hickey; M P Wilkes; D Howes; J Watt; C P Shearman
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  9     ISSN:  1078-5884     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  1995 Jan 
Date Detail:
Created Date:  1995-10-12     Completed Date:  1995-10-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  93-6     Citation Subset:  IM    
Affiliation:
Department of Surgery, Queen Elizabeth Hospital, Edgbaston, Birmingham, U.K.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anesthesia, Epidural*
Arteriovenous Shunt, Surgical
Bupivacaine
Case-Control Studies
Female
Femoral Artery / surgery*
Humans
Ischemia / physiopathology,  surgery*
Leg / blood supply*
Male
Prospective Studies
Regional Blood Flow / physiology
Saphenous Vein / transplantation*
Vascular Resistance / physiology
Chemical
Reg. No./Substance:
2180-92-9/Bupivacaine

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


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