Abstract

MORENO, L González et al. Peripheral regional anesthesia for arterial revascularization of lower limbs. Bibliographical review and clinical cases. Anest Analg Reanim [online]. 2016, vol.29, n.2, pp.45-69. ISSN 0255-8122.

Background:

The current trend is to defer revascularization surgery from lower limbs to advanced stages, which explains why they are more complex patients with high cardiac and respiratory mortality. The choice of anesthetic technique remains controversial. Regional blockades have potential advantages, such as hemodynamic and respiratory stability. Our primary objective was a bibliographic review to assess the peripheral blockages for anesthesia in lower limb revascularization surgery. Our secondary objective was report two clinical cases.

Material and methods:

The search was performed through the Medline, LILACS and SciELO database. We included studies where peripheral blocks were used for anesthesia. Two clinical cases are described.

Results:

Four original articles were selected, 3 of which were descriptive studies of the technique and the fourth a comparison with general inhalation anesthesia. 2 more corresponded to clinical cases.

Conclusions:

There is insufficient evidence to conclude that peripheral nerve block reduce mortality or morbidity when compared with other anesthetic techniques. This may be due to the methodological design of the studies, to the non-use of echocardiography as a guide and the non-systematization of the blocks. The analysis of the clinical cases suggests that this technique is a good option in specific situations as patients with high cardiac and respiratory risk, under treatment with anticoagulants and antiplatelets drugs.

Keywords : Peripheral vascular surgery; Regional anesthesia; Nerve block; Anesthesia, Regional; Femoral nerve block; Sciatic nerve block.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )