Gelman S

Language: English
References: 23
Page: 73-75
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Anesthesiologists have debated for many years whether regional anesthesia is better than general anesthesia for patients undergoing peripheral vascular surgery. Many studies that demonstrated significant advantages of regional anesthesia over general anesthesia for the patient population in question often had uneven distribution of sick patients between the groups, small sample size, an unclear description and, sometimes, inadequate anesthetic management. Thus, many studies in this area are weak in experimental design and therefore, have not produced definite answers. However, there are some relatively clear and convincing data confirming certain advantages of regional anesthesia for this patient population. One of them is a better pulmonary function and overall pulmonary outcome after regional anesthesia than after general anesthesia during the post-operative period.

REFERENCES

1. Gelman S. General versus regional anesthesia for peripheral vascular surgery. Is the problem solved? Anesth 1993;79:415-418.

2. Wu CL, Fleisher LA. Outcomes research in regional anesthesia and analgesia. Internat Anest Res Soc 2000;91:1232-1242.

3. Park WY, Thompson JS, Lee KK and Department of Veterans Affairs Cooperative Study #345 Study Group. Effect of epidural anesthesia and analgesia on perioperative outcome. A randomized, controlled veterans affairs cooperative study. Ann Surg 2001;234:560-571.

4. Rigg JRA, Jamrozik K, Myles PS, Silbert BS, Peyton PJ, Parsons RW, Collins KS for the Masters Anaesthesia Trial Study Group. Epidural anaesthesia and analgesia and outcome of major surgery: A randomized trial. Lancet 2002;359:1276-1282.

5. Singh N, Sidawy AN, Dezee K, Neville RF, Weiswasser J, Arora S, Aidinian G, Abularrage C, Adams E, Khuri S, Henderson WG. The effects of the type of anesthesia on outcomes of lower extremity infrainguinal bypass. J Vasc Surg 2006;44:964-970.

6. Ballantyne JC, Carr DB, deFerranti S, Suarez T, Lau J, Chalmers TC, Angelillo IF, Mosteller F. The comparative effects of postoperative analgesic therapies on pulmonary outcome: Cumulative meta-analyses of randomized, controlled trials. Anesth Analg 1998;86:598-612.

7. Ballantyne JC, Kupelnick B, McPeek B, Lau J. Does the evidence support the use of spinal and epidural anesthesia for surgery? J Clin Anesth 2005;17:382-391.

8. Lunn JK, Dannemiller FJ, Stanley TH. Cardiovascular responses to clamping of the aorta during epidural and general anesthesia. Anesth Analg 1979;58:372-376.

9. Bunt TJ, Manczuk M, Varley K. Continuous epidural anesthesia for aortic surgery: thoughts on peer review and safety. Surg 1987;101:706-714.

10. Davis RF, DeBoer LWV, Maroko PR. Thoracic epidural anesthesia reduces myocardial infarct size after coronary artery occlusion in dogs. Anesth Analg 1986;65:711-717.

11. Tuman K, McCarthy RJ, March R, Ivankovich AD. Effects of epidural anesthesia and analgesia on coagulation and outcome after major vascular surgery. Anesth Analg 1991;73:696-704.

12. Bode RH Jr, Lewis KP, Zarich SW, Pierce ET, Roberts M, Kowalchuk GJ, Satwicz PR, Gibbons GW, Hunter JA, Espanola CC. Cardiac outcome after peripheral vascular surgery: Comparison of general and regional anesthesia. Anesth 1996;84:3-13.

13. Rogers A, Walker N, Schug S McKee A, Kehlet H, van Zundert A, Sage D, Futter M, Saville G, Clark T, MacMahon S. Reduction of post-operative mortality and morbidity with epidural or spinal anaesthesia: Results from overview of randomized trials. Brit Med J 2000;321:1493-1497.

14. Garnett RL, MacIntyre A, Lindsay P, Barber GG, Cole CW, Hajjar G, McPhail NV, Ruddy TD, Stark R, Boisvert D. Perioperative ischaemia in aortic surgery: Combined epidural/general anaesthesia and epidural analgesia versus general anaesthesia and i.v. analgesia. Can J Anaesth 1996;43:769-777.

15. Liu S, Carpenter RL, Neal JM. Epidural anesthesia and analgesia: Their role in postoperative outcome. Anesth 1995;82:1474-1506.

16. Steinbrook RA. Epidural anesthesia and gastrointestinal motility Anesth Analg 1998;86:837-844.

17. Udelsman R, Ramp J, Gallucci WT, Gordon A, Lipford E, Norton JA, Loriaux DL, Chrousos GP. Adaptation during surgical stress. A reevaluation of the role of glucocorticoids. J Clin Invest 1986;77:1377-1381.

18. Hjortso NC, Neumann P, Frosig F, Andersen T, Lindhard A, Rogon E, Kehlet H. A controlled study on the effect of epidural analgesia with local anaesthetics and morphine on morbidity after abdominal surgery. Acta Anaesth Scand 1985;29:790-796.

19. Christopherson R, Beattie C, Frank SM, Norris EJ, Meinert CL, Gottlieb SO, Yates H, Rock P, Parker SD, Perler BA, Williams GM. Perioperative morbidity in patients randomized to epidural or general anesthesia for lower extremity vascular surgery. Anesth 1993;79:422-434.

20. Rosenfeld BA, Beattie C, Christopherson R, Norris EJ, Frank SM, Breslow MJ, Rock P, Parker SD, Gottlieb SO, Perler BA, Williams GM, Seidler A, Bell W, the Perioperative Ischemia Randomized Anesthesia Trial Study Group. The effect of different anesthetic regimens on fibrinolysis and the development of postoperative arterial thrombosis. Anesth 1993;79:435-443.

21. Vandermeulen EP, Van Aken H, Vermylen J. Anticoagulants and spinal-epidural anesthesia. Anesth Analg 1994;79:1165-1177.

22. Wulf H. Epidural anaesthesia and spinal haematoma. Can J Anaesth 1996;43:1260-1271.

23. Reinhart K, Foehring U, Kersting T, Schaefer M, Bredle D, Hirner A, Eyrich K. Effects of thoracic epidural anesthesia on systemic hemodynamic function and systemic oxygen supply-demand relationship. Anesth Analg 1989;69:360-369.