Anaesthesia for vascular surgery on the extremities

IF 0.2 Q4 ANESTHESIOLOGY

Anaesthesia and Intensive Care Medicine Pub Date : 2025-02-01 DOI:10.1016/j.mpaic.2024.11.007

Max Clayton-Smith

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Abstract

There are multiple types of procedure for vascular disease on the extremities, the majority of which are for the treatment of peripheral arterial disease (PAD). PAD is a common condition affecting 20% of people over the age of 60. Interventional treatment can be vascular, endovascular or combined (‘hybrid’) procedures by vascular surgeons and interventional radiologists.

PAD has risk factors in common with other atherosclerotic diseases which are often present, even if the patient is asymptomatic. Significant smoking histories are also common. Consequently, patients with PAD are a high-risk anaesthetic cohort. Comprehensive pre-operative assessment and investigation of the cardio-respiratory systems are essential to guide peri-operative planning. Multiple risk assessment tools are available to facilitate peri-operative decision making and risk-benefit discussions with patients.

The aim of intra-operative management is cardiovascular stability with proactive anticipation of events including haemorrhage and clamp release. Post-operatively regional anaesthesia is strongly advised particularly for patients undergoing amputation. Post-operative cardiac investigations may also be indicated.

Thoracic outlet syndrome and AV fistula formations are two specific clinical scenarios also covered in this topic.

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来源期刊

Anaesthesia and Intensive Care Medicine ANESTHESIOLOGY-

CiteScore

0.50

自引率

0.00%

发文量

152

期刊介绍： Anaesthesia and Intensive Care Medicine, an invaluable source of up-to-date information, with the curriculum of both the Primary and Final FRCA examinations covered over a three-year cycle. Published monthly this ever-updating text book will be an invaluable source for both trainee and experienced anaesthetists. The enthusiastic editorial board, under the guidance of two eminent and experienced series editors, ensures Anaesthesia and Intensive Care Medicine covers all the key topics in a comprehensive and authoritative manner. Articles now include learning objectives and eash issue features MCQs, facilitating self-directed learning and enabling readers at all levels to test their knowledge. Each issue is divided between basic scientific and clinical sections. The basic science articles include anatomy, physiology, pharmacology, physics and clinical measurement, while the clinical sections cover anaesthetic agents and techniques, assessment and perioperative management. Further sections cover audit, trials, statistics, ethical and legal medicine, and the management of acute and chronic pain.