Anesthetic management in patients undergoing endovascular surgery for abdominal aortic aneurysm repair [Endovasküler cerrahi uygulanan abdominal aorta anevrizmah hastalarda anestezi yönetimi]

We report our anaesthesia management in patients undergoing endovascular surgery for abdominal aortic aneurysm repair in our hospital between years 2004-2007. An epidural catheter was placed at L3-5 level before surgery and epidural anaesthesia was performed aiming a sensory level of T10 in 28 of the 32 patients undergoing endovascular surgery for abdominal aortic aneurysm repair. Four patients who had a contraindication to regional anaesthesia underwent general anaesthesia. Perioperative ECG and ST segment analysis, invasive arterial pressure, central venous pressure and oxygen saturation were monitorized for all patients. Arterial blood pressure was regulated with nitroglycerine and sodium nitroprusside infusions, as needed for all patients. Perioperative haemodynamic and respiratory parameters were retrospectively recorded. The patients had a mean age: 64.7±8.8 yrs, height: 168.5±6.2 cm, body weight: 72.5±9.2 kg, duration of procedure: 189.2±27.6 min and duration of anaesthesia: 214±24.9 min (mean±SD). The gender distribution was: (F/ M): 3/29 and ASA scores (I/II/III) were: 8/14/10. Preoperative coagulopathy was not documented in any patient. Perioperative haemodynamic stability was maintained for all patients; blood or blood products transfusion and vasopressor therapy were not required intraoperatively in any patient. Five patients required blood or blood products transfusion during the postoperative period. Acute arterial thrombosis and acute renal failure were complications encountered in two patients. In conclusion, anaesthesia technique should be chosen according to the duration of procedure, presence of coagulopathy and patient preference in patients undergoing endovascular surgeryfor abdominal aortic aneurysm repair.