Anaesthesia for vascular emergencies

Emergent vascular surgery is classified as being high risk and includes ruptured abdominal aneurysm repair, acute ischaemic limb revascularization and postoperative haematoma evacuation following carotid endarterectomy. These procedures are frequently performed out of normal working hours on patients who have significant comorbidities. A detailed pre-operative assessment and adequate preoptimization is usually precluded. As expected, associated morbidity and mortality rates are considerably higher than for the equivalent elective surgery. The anaesthetic technique employed should be carefully selected and applied as this plays a vital role in minimizing morbidity. Overall management can be challenging and requires experienced anaesthetic and surgical input from the outset.