Ultrasound-Guided peripheral nerve blocks for major amputation in critically ill patients with peripheral artery disease

作者全名："Wang, Haiyang; Yan, Zhitong; Nie, Menglin; Fu, Jian"

作者地址："[Wang, Haiyang; Yan, Zhitong; Nie, Menglin; Fu, Jian] Chongqing Med Univ, Affiliated Hosp 2, Dept Abdominal Wall Hernia & Vasc Surg, Chongqing, Peoples R China"

通信作者："Fu, J (通讯作者)，76 Linjiang Rd, Chongqing 400000, Peoples R China."

来源：ACTA CHIRURGICA BELGICA

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000850915600001

JCR分区：Q3

影响因子：0.8

年份：2022

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Amputation; peripheral nerve blocks; peripheral artery disease

摘要："Objective The aim of this study was to assess the safety and efficacy of major amputation under ultrasound-guided peripheral nerve blocks in critical peripheral artery disease (PAD) patients. Methods We reviewed the medical records of consecutive patients who underwent major amputation at our center between December 2012 and December 2020. The patients' baseline demographics and comorbidities were collected. The primary outcomes were 30-day and 12-month mortality. The secondary outcomes were intraoperative events, complications and intensive care unit (ICU) admission. Results Fifteen patients classified as American Society of Anesthesiologist (ASA) III and 13 ASA IV (mean age: 76.07 +/- 11.78 years) were included in the study. These patients were critically ill and had many comorbidities, such as coronary artery disease. All amputations were successfully performed under ultrasound-guided PNB without conversion to GA, but intravenous analgesia was given in 7 patients during the operation. The majority of the patients had stable hemodynamics except for 2 patients who had hypoxia, so none of the patients were transferred to the ICU postoperatively. None of the patients suffered from acute cardio-cerebral events. However, 5 patients had wound infections, and 4 of 5 patients had to receive reamputation. None of the patients died within 48 h after amputation. However, the 30-day mortality was 3.57%, and the 12-month mortality was up to 35.71%. Conclusion This study demonstrates that major amputation could be safely and effectively performed under ultrasound-guided peripheral nerve blocks for critically ill patients, and ultrasound-guided peripheral nerve blocks could be an alternative for patients at high risk of general anesthesia or spinal anesthesia."

基金机构：Chongqing medical scientific research project (Chongqing Health Commission ) [2020FYYX194]; Chongqing medical scientific research project (Science and Technology Bureau) [2020FYYX194]

基金资助正文：This work was supported by the Chongqing medical scientific research project (Joint project of Chongqing Health Commission and Science and Technology Bureau) (2020FYYX194).