Anesthesia for endovascular abdominal aortic aneurysm repair
Técnica anestésica para reparo endovascular de aneurisma de aorta abdominal
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Abstract
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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