Anesthesia clinical practices in limb amputations

Objective: We aimed to examine the anesthesia practices and postoperative complications of amputation surgeries performed in our clinic and to improve the anesthesia management of amputation surgeries with the data we obtained. Material and Method: Within the scope of our study, the data of 538 patients who underwent upper and lower limb amputation surgery in our clinic between 2011-2018 were scanned through the hospital information management system and file, and the necessary data were recorded. The recorded data are as follows; demographic data of the patient, surgical diagnosis and surgery, intraoperative data, preoperative laboratory values, comorbidities, perioperative complications, discharge and exitus times. Results: 73.2% of 538 patients who underwent amputation surgery were male. 47% consists of patients with ASA III and above. The average age and weight of the patients were 55.55 ± 19.08 years and 72.74 ± 15.44 kg, respectively. General anesthesia was applied to exactly half of the patients. 50.7% of the patients had amputation surgery due to diabetes, 19% due to ischemic causes and 16.2% due to trauma. 68.5% of the patients have comorbidities and the most common additional disease is diabetes mellitus with 62%. Transfusion was applied to 7.8% of the patients during surgery. Perioperative complications were observed in 32.9% of the patients. The most common intraoperative complications are hypotension and bleeding with 30.5%. The most common postoperative complication is wound complications with 22.5%. Although the possibility of complications increases as the ASA score and age increase, gender and smoking do not affect the risk of complications. Surgical indication does not increase the risk of complications. Statistically significantly more complications were observed in patients undergoing general anesthesia (p <0.05). The presence of additional disease does not affect the risk of complications (p> 0.05). Conclusion: According to the data we obtained as a result of the study, more postoperative intensive care need, death rate and perioperative complications are observed in amputation patients undergoing general anesthesia, and hospitalization periods are prolonged. Perioperative complications are more common in patients who have had recurrent surgeries. Key Words: Amputation, Anesthesiology, Limb, Lower, Upper