[Utility of the brachial plexus block combined with continuous intradural anesthesia for axillo-femoral bypass surgery]

Extra-anatomic axillofemoral bypass is a surgical procedure that is indicated in cases of occlusive aortoiliac pathology in which the transabdominal way is not feasible or in patients of high risk. We present a preliminary study in which we have prospectively evaluated 14 patients who were received an axillofemoral bypass during 1990. After preoperative evaluation two groups were identified: Group ALR (5 patients) with combined anesthetic blockade of supraclavicular brachial plexus and continuous subarachnoid blockade. Group AG (9 patients) who received balanced general anesthesia. In all cases we obtained a good anesthetic level for surgery. The incidence of complications was similar in both groups. One patient subjected to general anesthesia died. Combined blockade induces a satisfactory analgesia in all surgical interventions without exceeding in any case the maximal doses of anesthetic drugs. Additionally, this technique affords the advantages of regional anesthesia and can be used as an alternative anesthetic procedure in patients of high risk who undergo axillofemoral bypass.