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- W2019946232 abstract "The patient with peripheral vascular disease is usually at a considerably increased operative risk owing to coexisting, generalized, cardiovascular atherosclerotic involvement; hypertension; chronic bronchitis and diabetes. Regional (most often epidural) as well as general anaesthesia is commonly used for vascular surgical procedures of the lower limb. Although regional anaesthesia is sometimes considered associated with fewer overall perioperative complications than general anaesthesia, there is a lack of convincing evidence clearly demonstrating a major difference in overall outcome related to the choice of anaesthetic approach. The sympathetic nerve block induced by epidural anaesthesia may, however, be advantageous, since leg blood flow is enhanced, which may be of importance for postoperative graft function. The risk of local complications to central blocks must always be considered, especially in vascular surgery patients who receive anticoagulants during the revascularization procedure. Since haemorheological abnormalities play an important role in the pathophysiology of circulatory disease, it seems essential to use perioperative fluid regimens which reduce blood viscosity and enhance blood flow. Colloid-containing fluids are preferred to crystalloids owing to better intravascular volume supporting capacity and specific colloid-associated pharmacological effects on haemorheological variables. Hypertonic saline (7.5% NaCl) in combination with colloid may be the future intraoperative fluid regimen of choice for peripheral vascular reconstructive surgery." @default.
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- W2019946232 date "1999-08-01" @default.
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- W2019946232 title "Anaesthesia for vascular surgery of the lower limb" @default.
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