Location
LSU Health Sciences Center - New Orleans
Event Website
https://digitalscholar.lsuhsc.edu/surgery_s/
Document Type
Event
Start Date
4-5-2023 9:10 AM
End Date
4-5-2023 9:20 AM
Description
INTRODUCTION
Revascularization is vital in treating peripheral arterial disease (PAD). When medical management fails, patients with severe claudication and critical ischemia can undergo Percutaneous Transluminal Angioplasty (PTA). The patient population requiring PTA often has numerous comorbidities, and we propose these patients may experience fewer adverse events when regional anesthesia is utilized in lieu of general anesthesia.
The primary objective of this study is to determine whether patients who received regional anesthesia with femoral and sciatic nerve block had a lower rate of morbidity post-procedure versus patients who received general anesthesia for PTA for lower extremity revascularization.
METHODS
A retrospective chart review of patients > 18 years old who underwent technically successful PTA of a lower extremity between January 1, 2019 and December 31, 2020. Exclusion criteria include: prior complications with anesthesia, and bilateral revascularization procedure. Primary outcome is morbidity within 30 days of the procedure including myocardial infarction (MI), cerebrovascular accident (CVA), and acute kidney injury (AKI). Secondary outcomes include ICU stay, mortality, re-intubation, opioid use during and 24 hours after procedure, and nausea and vomiting (PONV).
RESULTS
A total of 81 patients were compared. After comparison, only one patient in each group had expired in the 30 days postoperatively (p=1). There were significant differences in patient opiate requirements between the groups. The regional anesthesia group received less intraoperative opioids than the general anesthetic group (p=0.0001). Conversely, the regional anesthetic group received more opiates during the postoperative period. Secondary outcomes of ICU admissions, ICU discharge time, need for postoperative ventilation or reintubation, development of postoperative nausea or vomiting, postoperative MI, postoperative AKI, postoperative CVA produced insignificant differences in rates between the two groups.
CONCLUSION
Regional anesthesia showed largely equivocal outcomes in patient morbidity and mortality, and is a safe, cost-effective alternative to general anesthesia in patients with PAD requiring PTA.
Recommended Citation
Primeaux, Austin; Norlin, C.; Broussard, Brannon; Shaw, Meredith; Tortorich, Gregory; Gallardo, Jose; Gayle, Julie; and Eng, Matthew R., "Retrospective Study of Regional Anesthesia or General Anesthesia for Percutaneous Transluminal Angioplasty" (2023). Surgery Research Symposium. 8.
https://digitalscholar.lsuhsc.edu/surgery_s/2023/postera/8
Included in
Retrospective Study of Regional Anesthesia or General Anesthesia for Percutaneous Transluminal Angioplasty
LSU Health Sciences Center - New Orleans
INTRODUCTION
Revascularization is vital in treating peripheral arterial disease (PAD). When medical management fails, patients with severe claudication and critical ischemia can undergo Percutaneous Transluminal Angioplasty (PTA). The patient population requiring PTA often has numerous comorbidities, and we propose these patients may experience fewer adverse events when regional anesthesia is utilized in lieu of general anesthesia.
The primary objective of this study is to determine whether patients who received regional anesthesia with femoral and sciatic nerve block had a lower rate of morbidity post-procedure versus patients who received general anesthesia for PTA for lower extremity revascularization.
METHODS
A retrospective chart review of patients > 18 years old who underwent technically successful PTA of a lower extremity between January 1, 2019 and December 31, 2020. Exclusion criteria include: prior complications with anesthesia, and bilateral revascularization procedure. Primary outcome is morbidity within 30 days of the procedure including myocardial infarction (MI), cerebrovascular accident (CVA), and acute kidney injury (AKI). Secondary outcomes include ICU stay, mortality, re-intubation, opioid use during and 24 hours after procedure, and nausea and vomiting (PONV).
RESULTS
A total of 81 patients were compared. After comparison, only one patient in each group had expired in the 30 days postoperatively (p=1). There were significant differences in patient opiate requirements between the groups. The regional anesthesia group received less intraoperative opioids than the general anesthetic group (p=0.0001). Conversely, the regional anesthetic group received more opiates during the postoperative period. Secondary outcomes of ICU admissions, ICU discharge time, need for postoperative ventilation or reintubation, development of postoperative nausea or vomiting, postoperative MI, postoperative AKI, postoperative CVA produced insignificant differences in rates between the two groups.
CONCLUSION
Regional anesthesia showed largely equivocal outcomes in patient morbidity and mortality, and is a safe, cost-effective alternative to general anesthesia in patients with PAD requiring PTA.
https://digitalscholar.lsuhsc.edu/surgery_s/2023/postera/8