Anesthesia for endovascular abdominal aortic aneurysm repair

Técnica anestésica para reparo endovascular de aneurisma de aorta abdominal

Abdominal aortic aneurysm is very common in our country and worldwide, thus, an understanding of anesthetic management and anesthesia long-term implications is essential.
Objective: To compare the anesthetic techniques used in patients who underwent prosthetic [stent-graft] endovascular abdominal aortic aneurysm repair between January 2009 and January 2015 at Hospital de San José in Bogotá.
Methods: A descriptive retrospective study including patients aged 18 years and older who had an EVAR. Those with ruptured aneurysms, who underwent emergency operations or open procedures, were excluded.
Results: Out of 79 EVARs, 58 (73.4%) were performed in men, the most common antecedents were, hypertension (68.3%), chronic obstructive pulmonary disease (20.2%) and tobacco smoking (15.1%). Local anesthesia associated with sedation was the most frequently used technique (50.6%), followed by general anesthesia (39.2%) and regional anesthesia (10.1%); the latter provided greater hemodynamic stability and reduced need for vasopressor agents and inotropes. Thirty-three (41.7%) anesthesia complications were observed.
Conclusions: Local anesthesia with sedation was the most frequently used technique pre- dominantly in cases with concomitant comorbidities. Operating time and length of stay in hospital was similar to that of general anesthesia, with fewer complications; regional anesthesia required less use of vasopressor and inotropic support.

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