Risks of Propofol-based Total Intravenous Anesthesia Compared with Local Anesthesia in Patients Undergoing Percutaneous Transluminal Angioplasty in The Lower Extremity
DOI:
https://doi.org/10.31584/jhsmr.2020747Keywords:
critical limb ischemia, local anesthesia, percutaneous transluminal angioplasty, peripheral artery disease, propofol-based total intravenous anesthesiaAbstract
Objective: This study aimed to determine the risks of propofol-based total intravenous anesthesia (TIVA) compared to local anesthesia (LA) in patients undergoing percutaneous transluminal angioplasty (PTA) in a lower extremity.
Material and Methods: A retrospective cohort study was conducted in 231 patients who underwent PTA in the lower extremity using either propofol-based TIVA or LA between January 2016 and September 2018. The outcomes of interest included perioperative major adverse cardiac events (MACE) and minor perioperative complications. Risk factors analysis was performed using a univariate logistic regression and backward stepwise multivariate logistic regression.
Results: Although the rate of perioperative MACE was two times higher in the propofol-based TIVA group (7.8%) than the LA group (3.9%), no significant difference was found (p-value=0.221). The propofol-based TIVA group had a significantly higher incidence of all minor perioperative complications than the LA group (77.6% vs 13.6%, p value<0.001). Multivariate analysis found that low body mass index (BMI) and American Society of Anesthesiologists classification III were independent factors associated with perioperative MACE, while propofol-based TIVA, body weight (or BMI), hypertension, diabetes mellitus, previous coronary artery disease, and previous congestive hear failure were associated with perioperative minor complications.
Conclusion: Based on this study, no significant differences in perioperative MACE were found using either TIVA or LA. However, TIVA produced a significantly higher incidence of perioperative minor complication than LA. Close intraoperative monitoring should be implemented when using propofol-based TIVA in patients undergoing PTA in the lower extremity.
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