M N D Di Minno1, M Milone, A Russolillo, R Lupoli, A Di Minno, P Maietta, C Iacovazzo, G Salvatore, F Milone.
Abstract
BACKGROUND: Peripheral arterial disease (PAD) predicts cardiovascular and cerebrovascular ischemic events. PAD treatment is aimed at reducing clinical symptoms, local tissue loss and at preventing complications. AIMS: To evaluated the effect of peridural analgesia on peripheral perfusion and pain control.
METHODS: In 280 diabetic subjects with severe limb ischemia (65.7% males and 34.3% females, mean age 59.3±14.4 years) with a failure of medical treatment and contraindications to endovascular and/or surgical reperfusion, we performed a 30-day long peridural ropivacaine infusion, monitoring blood pressure, VAS and ABI periodically.
RESULTS: During ropivacaine infusion VAS significantly decreased (from 4.06±0.343 to 1.96±0.413, p<0.001). Furthermore, in the 261 (93.2%) subjects achieving a VAS value ≤2 during infusion, the effect was maintained after infusion withdrawing. ABI significantly improved both during infusion (from 0.30±0.04 at baseline to 0.65±0.05 at T30, p<0.001) and after infusion withdrawing as compared with baseline values.
CONCLUSIONS: 30-day peridural analgesia with ropivacaine is a valuable therapeutic option in severe peripheral limb ischemia subjects with contraindication to surgery and with pharmacological therapy failure. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.
BACKGROUND: Peripheral arterial disease (PAD) predicts cardiovascular and cerebrovascular ischemic events. PAD treatment is aimed at reducing clinical symptoms, local tissue loss and at preventing complications. AIMS: To evaluated the effect of peridural analgesia on peripheral perfusion and pain control.
METHODS: In 280 diabetic subjects with severe limb ischemia (65.7% males and 34.3% females, mean age 59.3±14.4 years) with a failure of medical treatment and contraindications to endovascular and/or surgical reperfusion, we performed a 30-day long peridural ropivacaine infusion, monitoring blood pressure, VAS and ABI periodically.
RESULTS: During ropivacaine infusion VAS significantly decreased (from 4.06±0.343 to 1.96±0.413, p<0.001). Furthermore, in the 261 (93.2%) subjects achieving a VAS value ≤2 during infusion, the effect was maintained after infusion withdrawing. ABI significantly improved both during infusion (from 0.30±0.04 at baseline to 0.65±0.05 at T30, p<0.001) and after infusion withdrawing as compared with baseline values.
CONCLUSIONS: 30-day peridural analgesia with ropivacaine is a valuable therapeutic option in severe peripheral limb ischemia subjects with contraindication to surgery and with pharmacological therapy failure. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.
Entities:
Mesh：
Substances：
Year: 2012
PMID： 23147211 DOI： 10.1055/s-0032-1327757
Source DB: PubMed Journal: Exp Clin Endocrinol Diabetes ISSN： 0947-7349 Impact factor: 2.949