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Local anaesthetic for lower-limb revascularization in high-risk patients
C A Mackay1, W Razik, M H Simms
1Accident and Emergency Department, Selly Oak Hospital, Birmingham, UK.
Background:
A few patients with critical limb ischaemia are believed to be too unfit for an attempt at revascularization using conventional anaesthesia.
Methods:
A retrospective analysis was undertaken of 46 revascularization procedures performed in high-risk patients for critical limb ischaemia between 1989 and 1995, in which local anaesthetic techniques were utilized in preference to general or spinal anaesthesia.
Results:
Cumulative survival rates at 6, 12 and 24 months were 67, 57 and 51 per cent. Primary patency rates were 77 per cent at 6 months, 67 per cent at 12 months and 53 per cent at 24 months, with associated limb salvage rates of 87, 87 and 79 per cent.
Conclusion:
Selective use of local anaesthetic techniques extends the benefits of limb salvage to patients considered unfit for conventional anaesthesia.