Regional Anesthesia

Abstract

Major vascular surgical procedures are commonly performed on patients with significant comorbidities. Regional anesthetic techniques may be used as the primary mode of anesthesia or to supplement general anesthesia for open or endovascular surgical procedures. This chapter focuses on the management of thoracic and abdominal aortic repair, as well as revascularization of the lower extremities. Although general anesthesia is still used in a majority of these surgeries, neuraxial and regional options allow for the reduction of opioid administration and provide hemodynamic stability while maintaining safety. An understanding of vascular anatomy, the surgical procedure, as well as neuraxial or regional anesthesia technique, is critical for success. Finally, anticoagulant medication management, coordination of the timing of the procedure, and postoperative management are crucial to reduce the risk of complications in this challenging patient population.