Postoperative care and analgesia in vascular surgery

Patients undergoing major vascular surgery are at high risk for myocardial infarction, renal failure, respiratory complications and death. Invasive procedures confer greater risk of complication, with patients undergoing open aortic surgery being at highest risk. Endovascular procedures are less invasive, yet not devoid of potentially serious complications. Reduction of myocardial oxygen demand is key, as is stabilizing cardiovascular parameters, maintaining normothermia, adequate volume resuscitation and effective analgesia. Continuation of preoperative risk-reduction strategies including aspirin, β-blockers and statin therapies are critical, and should be continued in the postoperative period. Additionally, maintaining a high index of suspicion for procedure-specific complications is essential to reduce morbidity and mortality in these patients.