Trials Suggest Regional Anaesthesia Better Option for Vascular Surgery Patients

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Research had shown vascular surgery patients were less likely to experience complications if they underwent regional anaesthesia during procedures, Honorary Associate Professor Bruce Biccard of the Department of Anaesthetics at UKZN told a College of Health Sciences Research Symposium.

Biccard was speaking on results from a study titled: “General vs Neuraxial Anaesthesia in Decreasing Postoperative Mortality and Morbidity Following Vascular Surgery: A Meta-Analysis”, which aimed to determine whether neuraxial anaesthesia (with or without general anaesthesia) was superior to general anaesthesia alone in decreasing postoperative complications in patients undergoing vascular surgery.

The study was part of a masters project by Dr Avintha Ramkisson, a registrar in anaesthesia in the Department of Anaesthetics. Ramkisson will write her final fellowship examinations next year.

Regional anaesthesia is a technique which uses local anaesthetics to establish analgesia of peripheral nerves.

‘Arteries carry blood and nutrients to the body and when these arteries are damaged, vascular surgeons operate on the arteries to restore the flow of blood to the body,’ said Biccard.

‘Regional anaesthesia makes surgery possible without having to necessarily put the patient to sleep for the operation.’

Biccard said the study was a meta-analysis, which is a summary of all the literature up to this point. ‘It is a summary of what we know about this question. This meta-analysis revealed that patients do better with regional anaesthesia.’

Based on the results of 17 trials, acute respiratory failure, pneumonia and surgical morbidity were significantly decreased in patients randomised to neuraxial blockade.

‘Although this maybe the case, the findings would have to be tested in a big international trial,’ he added.

Biccard is currently involved in studies to improve perioperative outcomes for patients. ‘At the moment we are leading the African Surgical Outcomes Study which will look at surgical outcomes in all adult surgical patients across Africa.’

Biccard believes in better health for all through collaborative research.

Nombuso Dlamini