Contraindications to use of neuraxial anesthesia for lower limb revascularization surgery in adults: a cross-sectional study
Authors' conclusion
Most patients undergoing lower limb revascularization surgery did not have absolute contraindications to neuraxial anesthesia. When present, contraindications typically related to anticoagulation. Admission, procedure, comorbidity, and laboratory data did not provide adequate accuracy to ascertain contraindication status.
Study context
- Population
- Adults undergoing open lower limb revascularization surgery at The Ottawa Hospital, 2019–2021
- Participants
- 340 cases
- Outcome
- Prevalence of contraindications to neuraxial anesthesia
Methodological detailshistorical, single-centre, derivation and internal validation of case ascertainment algorithms
- Historical
- Single-centre
- Derivation and internal validation of case ascertainment algorithms
Main finding
As reported in the abstract
Absolute contraindications, n
78 (22.9%; 95% CI, 18.8 to 27.7) (%; 95% CI)
Absolute contraindications primarily due to anticoagulation or antiplatelet medication
89.4%
Relative contraindications, n
21 (6.2%; 95% CI, 4.1 to 9.3) (%; 95% CI)
Relative contraindications primarily long anticipated duration of surgery
16/21, 76.2%
Observational data: associations, not effects.
Further findings
Anesthesia technique used
- GA
- 219 (64.4%)
- Isolated neuraxial (spinal and/or epidural)
- 106 (31.2%)
- GA plus neuraxial
- 15 (4.4%)
Case ascertainment algorithms (3 nested)
- Admission and procedure variables: moderate discrimination, moderately explained variance, calibration inadequate for reliable use
- Comorbidity and laboratory data did not improve algorithm performance
Original publication
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