Local infiltration anesthesia with lidocaine for revascularization of peripheral artery in elderly patients
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    Abstract:

    Objective To investigate an ideal anesthetic method which has few complications and provides an adequate surgical environment for revascularization of peripheral artery. Methods From December 2004 to June 2010, 212 patients were enrolled, including 143 patients with an occluded superficial femoral artery and 13 iliac artery occlusion diagnosed by angiography, and complicated with life style-limiting intermittent claudication or rest pain, and 56 patients with renal failure undergoing hemodialysis. Revascularization of peripheral artery was performed under local infiltration anesthesia with lidocaine(0.22%), including 13 femoral-femoral, 143 above knee femoral-popliteal bypass grafts, and 56 artery-vein bypass grafts. American Society of Anesthesiologists(ASA) grade and complications were evaluated preoperatively. Anesthetic dose, visual analogue scale(VAS), Bruggrmann comfort scale(BCS), and perioperative complications were recorded. Additionally, mean artery pressure(MAP), heart rate(HR), and saturation pulse oxygen(SpO2) in the morning, at incision, at 1 hour, and at the end of the operation, were also recorded. Results All patients tolerated the procedure well. The surgical environment was satisfactory. BCS was (2.6±0.8).VAS was (3.0±2.1). MAP, HR, and SpO2 were not significantly different between different time points. The dosage of lidocaine(0.22%) was 350-487 mg, mean 417 mg. There was no perioperative death. Graft patency rate was 97.16%(206/212). Conclusion Lidocaine local infiltration anesthesia could provide a satisfactory surgical environment for revascularization of peripheral artery. This technique is easy to perform and has few complications, especially is adaptable to high-risk and elderly patients.

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