A systematic review and meta-analysis of general versus regional anesthesia for lower extremity amputation

Mufarrih, Syed Hamza; Qureshi, Nada Qaisar; Yunus, Rayaan; Katsiampoura, Anastasia D.; Quraishi, Ibrahim; Sharkey, Aidan; Mahmood, Feroze; Matyal, Robina

doi:10.1016/j.jvs.2022.10.005

Cited by 10 publications

(5 citation statements)

References 37 publications

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“…Nevertheless, it was noteworthy that in 35>51% of the cases, the following symptoms were identified separately: sore throat/hoarseness (35%), headache (33%) nausea and vomiting (34%), weakness and pain in the muscles (38%), and disorder of consciousness (35%). Reducing pain effectively lowers the chance of developing additional issues such as anxiety, thromboembolic processes, nausea and vomiting, or elevated blood pressure [20]. The findings of present study were very similar to the conclusion of a previous study in which patients reported the complaint of cold and chill in recovery room.…”

Section: Fig-3: Prevalence Of Physiological and Anatomical Complicati...supporting

confidence: 90%

Physio-Anatomical complications in short and long surgical procedures with General Anesthesia. A comparative cross-sectional study

Tanveer,

Qadeer,

Ali

et al. 2024

Dev. med. life sci.

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Background: The complication intensity of short- and long-term anesthesia during different surgeries depends upon the age, medical history and general lifestyle of a patient. Aims and objectives: The aims and objectives of present study were to evaluate the risks associated with general anesthesia during various surgical procedures. Methodology: Current comparative cross-sectional study was conducted in ICU, general surgery and gynecology units of Ghurki Trust and Teaching Hospital from July 2023 to February 2024. Total 100 patients of appendectomy and hysterectomy were selected as study subjects and divided into two groups. In Group-A (short surgery group) 65patients with appendectomy and in Group-B (Long surgery group) 35 women patients with hysterectomy were included. All of the clinical and demographic data were recorded on MS Excel and SPSS version 2024 were used to process, analyze, and distribute the data as needed and graph pad prism was used to plot graphical data representation. Results: The study identified a significant association between anesthesia duration and increased postoperative complications, notably in patients aged 51-55 years. Enhanced risks included postoperative pain, nausea, and respiratory distress, emphasizing the need for tailored anesthesia strategies based on surgical length and patient demographics. Conclusion: General anesthesia is largely safe but linked to some complications, necessitating innovative improvements and further research with larger sample sizes for enhanced safety.

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Section: Fig-3: Prevalence Of Physiological and Anatomical Complicati...supporting

confidence: 90%

Physio-Anatomical complications in short and long surgical procedures with General Anesthesia. A comparative cross-sectional study

Tanveer,

Qadeer,

Ali

et al. 2024

Dev. med. life sci.

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“…Peripheral nerve blocks play a crucial role in providing surgical anaesthesia as well as postoperative analgesia on patients receiving lower extremity amputation, with lesser complications, especially when both neuraxial and general anaesthesia cannot be performed 3. In general, ultrasound guidance has significantly improved the success of these peripheral nerve blocks 6.…”

Section: Discussionmentioning

confidence: 99%

“…The choice of anaesthesia can have an effect on these outcomes. While general anaesthesia is a popular choice, regional anaesthesia has lesser complications compared with general anaesthesia for lower limb amputation surgeries 3. It can be extremely useful as a choice of anaesthetic and for postoperative pain control in patients who cannot tolerate general anaesthesia due to their cardiopulmonary morbidity and who cannot have neuraxial anaesthesia due to contraindications such as being on anticoagulant medications and having coagulopathy.…”

Section: Introductionmentioning

confidence: 99%

Peripheral nerve blocks for through-knee amputation in a patient on extracorporeal membrane oxygenation

Seidler,

Terlep,

Ramanujam

2024

BMJ Case Rep

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A woman in her 40s with an ischaemic right lower limb, who was on extracorporeal membrane oxygenation (ECMO) following cardiopulmonary failure secondary to bilateral alveolar haemorrhage, was scheduled for through-knee amputation. She was under mechanical ventilation and continuous intravenous medications. Considering her significant comorbidities, peripheral nerve blocks were chosen for anaesthesia. Ultrasound-guided traditional nerve blockade techniques of the femoral and sciatic nerves were not possible because of the presence of an ECMO cannula, altered anatomy following previous surgery on the same side and inability to turn the patient to a lateral position. An ultrasound-guided trans fascia iliaca for femoral and anterior approach for sciatic were rather used to accomplish the nerve blockades. Surgery completed without any complications and with reduced postoperative outcomes such as opioid consumption, other morbidities and mortality. This report is unique as the literature on peripheral nerve block approaches for lower limb amputations in ECMO patients is sparse.

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“…Possible adverse events after general anesthesia encompass common complications (e.g., postoperative nausea and vomiting (PONV), laryngospasm, hypotension, and temporary neurocognitive disorders), and less frequent but potentially disastrous complications, which include respiratory failure, myocardial infarction, renal failure, and in extreme cases, death. [ 24 , 29 , 30 ] In detail, a meta‐analysis revealed that the global prevalence of PONV was 27.5% with an range between 6.7% and 73.4%. [ 26 ] Laryngospasm was found to frequently occur in pediatric patients with an incidence rate of 18.4%.…”

Section: Modern Anesthesia and Related Toxicitymentioning

confidence: 99%

“…[ 32 , 33 , 34 ] Among 69 754 patients receiving general anesthesia for lower extremity amputation, ≈6.7%, 1.5%, 2.0% of them experienced respiratory failure, myocardial infarction, and renal failure, respectively. [ 30 ]…”

Section: Modern Anesthesia and Related Toxicitymentioning

confidence: 99%

Nanotherapeutics for Alleviating Anesthesia‐Associated Complications

Lu,

Wei,

Shi

et al. 2024

Advanced Science

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Current management of anesthesia‐associated complications falls short in terms of both efficacy and safety. Nanomaterials with versatile properties and unique nano‐bio interactions hold substantial promise as therapeutics for addressing these complications. This review conducts a thorough examination of the existing nanotherapeutics and highlights the strategies for developing prospective nanomedicines to mitigate anesthetics‐related toxicity. Initially, general, regional, and local anesthesia along with the commonly used anesthetics and related prevalent side effects are introduced. Furthermore, employing nanotechnology to prevent and alleviate the complications of anesthetics is systematically demonstrated from three aspects, that is, developing 1) safe nano‐formulization for anesthetics; 2) nano‐antidotes to sequester overdosed anesthetics and alter their pharmacokinetics; 3) nanomedicines with pharmacodynamic activities to treat anesthetics toxicity. Finally, the prospects and challenges facing the clinical translation of nanotherapeutics for anesthesia‐related complications are discussed. This work provides a comprehensive roadmap for developing effective nanotherapeutics to prevent and mitigate anesthesia‐associated toxicity, which can potentially revolutionize the management of anesthesia complications.

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A systematic review and meta-analysis of general versus regional anesthesia for lower extremity amputation

Cited by 10 publications

References 37 publications

Physio-Anatomical complications in short and long surgical procedures with General Anesthesia. A comparative cross-sectional study

Physio-Anatomical complications in short and long surgical procedures with General Anesthesia. A comparative cross-sectional study

Peripheral nerve blocks for through-knee amputation in a patient on extracorporeal membrane oxygenation

Nanotherapeutics for Alleviating Anesthesia‐Associated Complications

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