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Neuraxial Anesthesia Best for Lower-Limb Revascularization Surgery

MONDAY, Dec. 7, 2020 -- For lower-limb revascularization surgery, use of neuraxial anesthesia is associated with reduced 30-day mortality and hospital length of stay, according to a study published online Nov. 25 in The BMJ.

Derek J. Roberts, M.D., Ph.D., from the University of Ottawa in Ontario, Canada, and colleagues conducted a comparative effectiveness study using linked, validated population-based databases for 20,988 Ontario adults who underwent their first lower-limb revascularization surgery from April 1, 2002, to March 31, 2015, in hospitals performing 50 or more of these surgeries annually.

The researchers found that 30.7 and 69.3 percent of the patients received neuraxial anesthesia and general anesthesia, respectively. Across included hospitals, the percentage of neuraxial anesthesia use ranged from 0.6 to 90.6 percent. During the study period, use of neuraxial anesthesia decreased by 17 percent. Deaths within 30 days occurred in 3.2 and 4.4 percent of patients who received neuraxial and general anesthesia, respectively. Use of neuraxial anesthesia versus general anesthesia correlated with a reduction in 30-day mortality after multivariable, multilevel adjustment (absolute risk reduction, 0.72 percent; odds ratio, 0.68). Compared with general anesthesia, use of neuraxial anesthesia also correlated with reduced in-hospital cardiopulmonary and renal complications (odds ratio, 0.73) and decreased length of hospital stay (−0.5 days).

"We hope this study will help patients and physicians make more informed decisions about what type of anesthetic is best for each patient," a coauthor said in a statement.

Abstract/Full Text

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Posted: December 2020

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