While endovascular treatments for peripheral artery disease (PAD) are on the rise, their safety, efficacy, and durability remain questionable. Hence, lower limb revascularization surgeries are preferred. This study aims to examine the clinical outcomes associated with neuraxial anesthesia and general anesthesia for lower limb revascularization surgery.
This comparative effectiveness study included a total of 20.988 patients aged 18 years or older who underwent their first lower limb revascularization surgery. The exposure to neuraxial anesthesia and general anesthesia was considered. The primary outcome of the study was 30-day all-cause mortality, and the secondary outcomes were in-hospital renal and cardiopulmonary complications.
Of 20,988 patients, 6,453 (30.7%) received neuraxial anesthesia and 14,535 (69.3%) received general anesthesia. The incidence of mortality within 30 days of administration occurred in 204 patients (3,2%) who received neuraxial anesthesia and 646 patients (4.4%) who received general anesthesia. Multivariable and multivariate adjustment showed that the use of neuraxial anesthesia was associated with a reduced incidence of 30-day mortality when compared with general anesthesia. Besides, the use of neuraxial anesthesia was also associated with a reduced risk of cardiopulmonary and renal complications.
The research concluded that neuraxial anesthesia was associated with a lower risk of 30-day mortality than general anesthesia for lower limb revascularization surgery.
Ref: https://www.bmj.com/content/371/bmj.m4104
