Experience of Peripheral Arterial Disease Surgery with Tumescent Local Anesthesia

Background: Peripheral arterial disease (PAD) is a chronic process of atherosclerosis, diabetes mellitus, hyperlipidemia, smoking, hypertension, stress and genetics. The most important symptom is ischemic claudication. General anesthesia, spinal anesthesia, local anesthesia can be performed in the surgical treatment of this disease. However, in cases where general and spinal anesthesia is very risky depending on the patient, it may be used in tumescent local anesthesia if surgery is to be performed in a large area. We retrospectively evaluated the cases in which we performed surgery for peripheral arteries with tumescent local anesthesia. Methods: Between January 2014 and September 2018, peripheral arterial patients operated with tumescent local anesthesia were evaluated retrospectively in a Training and Research Hospital. Tumescent local anesthesia can be applied to patients at risk and when we did not prefer other anesthesia applications. The research was performed on the patient files and the hospital information system. Results: A total of 11 patients underwent surgical treatment for peripheral arterial disease with tumescent local anesthesia. Femoro-popliteal bypass was used in five patients, axillo-femoral bypass in two patients, axillo bifemoral bypass in one patient, femoro-femoral bypass in one patient and axillo-axillary bypass in one patient. The anesthesia duration was 128.82 ± 10.25 and the operation duration was 107.91 ± 13.84 minutes. Perioperativly hemodynamic and general status of the patients were good with tumescent local anesthesia. Conclusion: Tumescent local anesthesia is an alternative form of application for general and spinal anesthesia patients who are too subtle and have low extremity ischemia. Close anesthesia follow-up and, if necessary, with sedoaneljezi support can be operated comfortably in patients with high operation risk.