Impact of Regional and General Anaesthesia for Below knee amputations on duration of post operative hospital stay and associated 30 day post-operative outcomes – A retrospective cohort study in a tertiary hospital in India

Lower limb amputationsare regularly performed as a life saving surgeries in the underlyingcircumstances of sepsis, peripheral arterial disease or trauma. Peripheral vascular disease (PVD) anddiabetes mellitus (DM) have been identified as primary risk factors for lowerlimb amputations. The reasons for limb loss can be classified into the followingcategories: patient-specific issues such as comorbidities, presence of footlesions, anatomical factors, and healthcare-related factors like access tohealthcare and medical insurance. Indications for amputation are related to the degree of tissue necrosisor viability, and it is performable in either a single operation or a stagedmanner. In general, soft tissue quality and the ability to obtain bone coveragewill guide the adequacy of the level of amputation. Patients who undergo LEA usually havecomorbidities, including hypertension, heart failure, and end-stage renaldisease and are likely to be in an older age group. Furthermore, these patientshave advanced systemic atherosclerotic disease involving not only theperipheral limbs but also the coronary, cerebral, and renal circulations. HenceAnaesthetic management for such patients is chosen carefully. Because of ultrasoundguidance, the usage of regional anaesthesia (RA) has increased since 2005.Additionally, compared to general anaesthesia (GA), RA has a number ofphysiological advantages, including as better stump flow, preservation of thebody’s physiological reaction to stress, and comparable or greater analgesiafollowing surgery.  Compared with GA,neuraxial anaesthesia, in particular, has been associated with lower 30-daymortality and decreased morbidity, less blood loss, fewer surgical site infections,and a decreased rate of admission to critical care services after electivetotal hip or knee arthroplasty. The aim of the study isto compare the impact of Regional Anaesthesia and General Anaesthesia on theLength of Hospital stay and mortality and morbidity of patients in the 30 daypost-op period in Indian Setting