Post-operative management following major vascular surgery

Literature has provided proof of the high complication rate in major vascular surgery. The post-operative metabolic stress includes a circulatory response and coagulation disorders, mainly hypercoagulability. Major cardiac complications include heart failure and acute coronary insufficiency, which can be best diagnosed by troponine Ic. Non-cardiac complications essentially damage the lungs and the kidneys. Post-operative management will be aimed at controlling post-operative stress by preventing hypothermia and providing adequate sedation and effective analgesia. Control of post-operative hypertension is mandatory. The use of prophylactic cardiovascular agents, such as β-adrenergic antagonists or α2-adrenergic agonists, permits a better control of sympathetic tone and its circulatory effects.