{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:42:46Z","timestamp":1787013766479,"version":"build-2736575974"},"reference-count":14,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,10,24]],"date-time":"2017-10-24T00:00:00Z","timestamp":1508803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The present study aimed to determine which method of anaesthesia (spinal anaesthesia or general anaesthesia) is better in reducing post\u2010operative analgesic requirements in patients undergoing major limb amputation for lower\u2010limb ischaemia. Another aim was to find out if anaesthesiologists use neuraxial anaesthesia in high\u2010risk patients despite abnormal coagulation profile or use of anticoagulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study was a retrospective cohort study. All patients undergone above\u2010the\u2010knee amputation or below\u2010the\u2010knee amputation due to peripheral artery disease between 1996 and 2010 were reviewed to evaluate post\u2010operative opioid consumption and complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 434 amputations in 323 patients were included in the study. The number of surgical complications, the need for surgical revision and the number of intensive care unit admissions were significantly higher in the general anaesthesia group. The need for post\u2010operative opioid medication was significantly lower in patients with above\u2010the\u2010knee amputation and spinal anaesthesia. The use of post\u2010operative epidural analgesia did not reduce analgesic requirements. In the present study, there were patients who received neuraxial anaesthesia despite abnormal coagulation profile or uninterrupted warfarin or clopidogrel. There were no reported cases of spinal or epidural haematoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with spinal anaesthesia had a lower rate of surgical complications, re\u2010operations and intensive care unit admissions. Patients with above\u2010the\u2010knee amputation and spinal anaesthesia had a lesser need for opioid medication in the post\u2010operative period than patients with general anaesthesia. Anaesthesiologists performed neuraxial anaesthesia and\/or analgesia in high\u2010risk patients despite abnormal coagulation profile or ongoing anticoagulation, but no adverse outcomes were reported.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aas.13019","type":"journal-article","created":{"date-parts":[[2017,10,24]],"date-time":"2017-10-24T03:32:36Z","timestamp":1508815956000},"page":"226-233","source":"Crossref","is-referenced-by-count":22,"title":["Spinal or general anaesthesia for lower\u2010limb amputation in peripheral artery disease \u2013 a retrospective cohort study"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0239-6526","authenticated-orcid":false,"given":"M.","family":"Niskakangas","sequence":"first","affiliation":[{"name":"Department of Surgery Oulu University Hospital Oulu 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Hospital Oulu Finland"},{"name":"Research Group of Surgery, Anesthesiology and Intensive Care Medicine Medical Research Center of Oulu University Oulu University Hospital Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Kaakinen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Oulu University Hospital Oulu Finland"},{"name":"Research Group of Surgery, Anesthesiology and Intensive Care Medicine Medical Research Center of Oulu University Oulu University Hospital Oulu 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