Epidural anesthesia reduces length of hospitalization after endoluminal abdominal aortic aneurysm repair

Cao, Piergiorgio; Zannetti, Simona; Parlani, Gianbattista; Verzini, Fabio; Caporali, S; Spaccatini, A.; Barzi, F

doi:10.1016/s0741-5214(99)70104-7

Cited by 62 publications

(46 citation statements)

References 25 publications

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“…They used midazolam for sedation in regional anesthesia group; so as to keep Ramsey sedation scale as 2. There was no significant difference between GA and RA, in terms of length of stay in ICU; however; the ones in RA group required less ICU referral [25]. Bettex et al, evaluated 91 patients, retrospectively.…”

Section: Discussionmentioning

confidence: 98%

Anesthetic Management and Perioperative Complications in Endovascular Interventions: The Turkish Experience

Erkılıç¹,

Kesimci²,

Döğer³

et al. 2015

Glob J Anesth

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Background and Aim: Thoracic, abdominal and thoraco-abdominal aortic pathologies have highest mortality and morbidity causing pathologies in cardiovascular surgery. Co-existing diseases and age significantly increase risk of anesthesia and mortality rate in treatment of these patients. Endovascular techniques are used increasingly due to minimally invasive approach, decreased anesthesia risk during implementation, reduced length of hospital stay, and low mortality and mobidity rates. The aim of this investigation was to report our anesthetic experiences in endovascular techniques performed at our center. Materials and Methods:We evaluated 120 (19 females, 101 males; mean age: 67±12 years) consecutive symptomatic patients with thoracic and abdominal aortic pathologies who underwent endovascular stent graft surgery with either general or regional anesthesia or sedoanalgesia between 2009 and 2014, at our center. Results:The number of patients having abdominal endovascular stent graft surgery was 81. Among the rest; 87% underwent thoracic endovascular aneurysm repair, while 13% had both of the interventions. The duration of anesthesia and surgery was not different among the intervention groups. 86.8% of patients had general anesthesia, while 12.3% and 0.9% had regional anesthesia and sedoanalgesia; respectively. Postoperatively, the rate of being intubated and the length of stay in intensive care unit were found significantly lower in endovascular aortic repair (EVAR) group.Conclusion: EVAR should be considered as a beneficial alternative treatment option for high-risk and inoperable, elderly patients. Anesthesiological approach to be selected in these patients may be affected not only by general condition and cooperation of the patient, but also by the location of the pathology and duration of the process. Thus, the anesthesiologists should be prepared to face issues related to the patient's safety both during the administration of anesthesia and in the postoperative period.for a consecutive series of patients who underwent endovascular abdominal and thoracalaneurysm repair in our institution within a 5-year period.

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Section: Discussionmentioning

confidence: 98%

Anesthetic Management and Perioperative Complications in Endovascular Interventions: The Turkish Experience

Erkılıç¹,

Kesimci²,

Döğer³

et al. 2015

Glob J Anesth

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“…24 Bir başka çalışmada ise, GA grubunda yoğun bakım kalış süresinin anlamlı oranda kısa (1,9 gün) olması ile birlikte, anestezi ve girişim sü-resinin kısa olduğu gözlenmiştir. 21 Ayrıca araştır-macılar, bu hastalardaki iyileşmede anestezi tekniğinden çok komorbid durumların önemli olduğunu belirtmişlerdir.…”

Section: Discussionunclassified

Our Anaesthetic Experiences in Endovascular Aortic Stent Graft Surgery

Özer¹,

Yilmaz²

2017

Turkiye Klinikleri J Cardiovasc Sci

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Ö ÖZ ZE ET T A Am ma aç ç: : Torakal ve torakoabdominal aort anevrizmaları ve diseksiyonları, cerrahi mortalite ve morbiditesi yüksek patolojilerdir. Eşlik eden farklı hastalıklar ve yaş belirgin olarak bu hastalardaki anestezi riskini ve mortalite hızını artırmaktadır. Cerrahi ve girişimsel radyolojideki deneyimlerin artması ile gelişen minimal invaziv endovasküler girişimler, uygulama sırasındaki anestezi riskini azalmakta, hastanede kalış süresini kısalmakta, ve düşük mortalite ve morbidite hızına yol açmaktadır. Bu çalışmada, TOBB Ekonomi ve Teknoloji Üniversitesi Hastanesinde uygulanmış olan endovasküler girişimlerdeki anestezi deneyimlerimizin aktarılması amaçlanmıştır. G Ge er re eç ç v ve e Y Yö ön n--t te em ml le er r: : Merkezimizde, Ocak 2012-Haziran 2017 tarihleri arasında, torasik ve abdominal aortik patolojiler nedeni ile endovasküler stent greftleme geçiren 70 (58 erkek, 12 kadın) semptomatik hastada uygulanan genel anestezi veya sedasyon ve lokal anestezinin etkinliği ve komplikasyonları değerlendirildi. B Bu ul lg gu ul la ar r: : Endovasküler stent greftleme geçiren hasta sayısı 70 idi. Olguların 58 (%82,9)'i erkek ve 12 (%17,1)'si kadın olmak üzere 40'ı ASA III idi. Olguların demografik özellik-lerinin, ASA durumlarının ve eşlik eden ek hastalıklarının karşılaştırmalarında anlamlı bir fark saptanmadı. Torakal endovasküler aort tamiri (TEVAR) yapılan hastalarımızın 24 (%34)'üne genel anestezi uygulanır iken, abdominal endovasküler aort tamiri (EVAR) yapılan hastalarımızdan 33 (%47)'üne genel, 13 (%19)'üne de sedasyon ve lokal anestezi uygulanmıştır. EVAR yapılan hastaların 28'inde, TEVAR yapılan hastaların ise 20'sinde hipertansiyon mevcuttu. Gruplar arasında kan ve kan ürünleri transfüzyonu, preoperatif ve postoperatif hemoglobin, hematokrit, üre ve kreatin değȇrleri açısından istatistiksel olarak anlamlı bir farklılık saptanmadı. S So on nu uç ç: : EVAR ve TEVAR uygulamalarında genel anestezi yapılır iken; sedasyon ve lokal anestezi hastanın durumuna ve işlem yapılacak alana bağlı olarak başarılı bir şekilde uygulanabilmektedir.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Anestezi, genel; aort anevrizması; endovasküler prosedürler A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Thoracic and thoraco-abdominal aortic aneurysms and dissections have highest mortality and morbidity causing pathologies in cardiovascular surgery. Co-existing diseases and age significantly increase risk of anesthesia and mortality rate in treatment of these patients. Endovascular techniques are used increasingly due to minimally invasive approach, decreased anesthesia risk during implementation, reduced length of hospital stay, and low mortality and mobidity rates. The aim of this investigation was to report our anesthetic experiences in endovascular techniques performed at TOBB University of Economics and Technology Hospital. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : We evaluated 70 (58 male, 12 female) consecutive symptomatic patients with thoracic and abdominal aortic pathol...

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“…Moreover, local anesthesia contributes to reduced length of hospitalization. 20,21 In addition, all patients received mannitol, which functions as a scavenger to attenuate the ischemic reperfusion response, which could have affected neutrophil activity. In vitro, mannitol decreases reactive oxygen metabolites and the respiratory burst of neutrophils, thus contributing to the attenuation of this function in all patients.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil Respiratory Burst Activity and Pro- and Anti-inflammatory Cytokines in AAA Surgery: Conventional versus Endoluminal Treatment

Parodi¹,

Ferreira

Fornari

et al. 2001

J Endovasc Ther

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Despite heterogeneity before surgery, the respiratory burst decreased for most of the patients regardless of the approach, and both techniques increased IL-1RA. Although both procedures seemed to decrease TGF-beta1, the difference was significant only with the conventional approach. IL-1RA levels fell toward basal values quicker in the endograft patients, suggesting that the endoluminal approach was less aggressive.

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Epidural anesthesia reduces length of hospitalization after endoluminal abdominal aortic aneurysm repair

Abstract: EA for EAAR is feasible in a high percentage of patients in whom it is attempted, and it ensures a technical outcome comparable with that of patients undergoing EAAR with GA. Successful completion of EAAR with EA is associated with a short period of hospitalization.

Cited by 62 publications

References 25 publications

Anesthetic Management and Perioperative Complications in Endovascular Interventions: The Turkish Experience

Anesthetic Management and Perioperative Complications in Endovascular Interventions: The Turkish Experience

Our Anaesthetic Experiences in Endovascular Aortic Stent Graft Surgery

Neutrophil Respiratory Burst Activity and Pro- and Anti-inflammatory Cytokines in AAA Surgery: Conventional versus Endoluminal Treatment

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