Comparative Effectiveness of Anesthesia Techniques on the Duration of Endovascular Lower-Extremity Revascularization:...

To compare the effects of peripheral nerve block anesthesia (PNBA) (ultrasound-guided iliac fascia and sciatic block) and monitored anesthesia care (MAC) on operative efficiency and postoperative outcomes in patients with lower-limb arteriosclerosis obliterans (ASO) undergoing endovascular revascularization.

Retrospective matched cohort study (1:1 propensity score matching).

Single-center analysis of patients undergoing ASO.

One hundred ninety-four matched pairs (N = 388) selected from 459 eligible patients.

PNBA (n = 194) versus MAC (n = 194).

In terms of primary outcomes, PNBA significantly reduced operative time across procedure types (stent implantation, 130.30 ± 60.079 minutes v 147.86 ± 68.155 minutes [p = 0.05]; balloon dilation, 137.79 ± 54.063 minutes v 179.97 ± 90.335 minutes [p < 0.001]) and age groups (≥65 years, 136.41 ± 57.771 minutes v 164.68 ± 81.373 minutes [p < 0.001]; <65 years, 121.39 ± 55.225 minutes v 158.57 ± 80.773 minutes [p = 0.023]). Secondary outcomes, including myocardial injury after noncardiac surgery, amputation, death, intensive care unit admission, renal function, and coagulation changes, were comparable (all p ≥ 0.05). Compared with MAC, the PNBA approach significantly relieved pain and improved patient satisfaction. Specifically, 80.9% of patients reported no pain, and 85.1% reported high satisfaction, compared with 15.4% and 5.2%, respectively, for the MAC approach (both p ≤ 0.001).

PNBA demonstrated significant advantages in lower-limb revascularization surgery for ASO, including reduced operative time, optimized perioperative analgesia, and improved patient satisfaction.