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Updated: Jun 16, 2026
03:14
Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia
Published on: January 31, 2025
Neuraxial anaesthesia for lower-limb revascularization.
Fabiano T Barbosa1, Jairo C Cavalcante, Mário J Jucá
1Department of Clinical Medicine, Armando Lages Emergency Hospital, 113, Comendador Palmeira, Farol, Maceió, Alagoas, Brazil, 57051150.
The Cochrane Database of Systematic Reviews
|January 22, 2010
Summary
Spinal and epidural anesthesia (neuraxial anesthesia) showed no significant differences in mortality, heart attack, or amputation rates for lower-limb revascularization. Neuraxial anesthesia may reduce pneumonia risk compared to general anesthesia.
Area of Science:
- Anesthesiology
- Vascular Surgery
- Evidence-Based Medicine
Background:
- Lower-limb revascularization surgery aims to alleviate pain and enhance limb function.
- The choice of anesthesia during this procedure can influence patient outcomes, both positive and negative.
Purpose of the Study:
- To compare the rates of mortality and major complications associated with spinal and epidural anesthesia versus other anesthetic techniques for lower-limb revascularization.
Main Methods:
- Systematic review of randomized controlled trials comparing neuraxial anesthesia with general anesthesia in adults undergoing lower-limb revascularization.
- Data extraction focused on primary outcomes: mortality, stroke, myocardial infarction, nerve dysfunction, and amputation. Pneumonia was a secondary outcome.
- Random-effects models were used to summarize dichotomous data, with heterogeneity assessed using the I² statistic.
Main Results:
- Four trials involving 696 participants were included. No significant differences were observed in mortality (OR 0.89, 95% CI 0.38-2.07), myocardial infarction (OR 1.23, 95% CI 0.56-2.70), or lower-limb amputation rates (OR 0.84, 95% CI 0.38-1.84) between neuraxial and general anesthesia.
- Pneumonia occurred less frequently with neuraxial anesthesia (OR 0.37, 95% CI 0.15-0.89).
Conclusions:
- Evidence is insufficient to rule out clinically significant differences for most outcomes between neuraxial and general anesthesia in lower-limb revascularization.
- Neuraxial anesthesia may be associated with a reduced risk of pneumonia.
- Further research is needed to draw definitive conclusions regarding mortality, myocardial infarction, and amputation rates.
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