Effects of anesthesia on leg blood flow in vascular surgical patients.

Studies suggest that epidural anesthesia has advantages over general anesthesia in patients with occlusive atherosclerotic disease undergoing vascular surgery in the lower limb. Epidural anesthesia allows maintenance of good hemodynamic stability and elicits no stress reactions. In addition, it does not compromise blood flow to the lower limb. Local anesthetic agents may exert potentially beneficial effects on the production of prostacyclin by endothelial cells, blood cell aggregation, and blood viscosity. All of these factors influence graft patency and thus the success of vascular surgery.