Abstract:
I owcr limb revascularisation is done for critical limb ischaemia due to proven arterial
occlusive disease and for acute limb ischaemia which occurs due to thromboembolism,
trauma, and percutaneous vascular interventions.
I <>wer limb revascularisation surgery is classified as high risk under American College of
( ardiology and American Heart Association guidelines on pre operative assessment.
Therefore pre operative cardiac risk assessment and institution of appropriate risk
icducing measures are important.
Aims of anaesthesia are to maintain haemodynamic stability, normothermia, meticulous
I n noperative fluid management and postoperative pain control. The anaesthetic
technique per se has no bearing on the outcome as the quality of the anaesthetic.
Ainlc limb ischaemia is an emergency to prevent limb loss. Patients are often i l l ; and
•OUgh the same cardiac considerations apply extensive pre operative evaluation is not
iJMiisible due to time constraints. Embolectomy would be performed under local
piesthesia with the anaesthetist monitoring the patient. When more invasive surgery is
ttinned general anaesthesia is preferred as patients would be receiving therapeutic doses
Mliinlicoagulants.
in both situations monitoring and management for reperfusion injuries is required.
