Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 1 de 1
Filter
Add more filters










Database
Language
Publication year range
1.
Int Angiol ; 29(3): 278-83, 2010 Jun.
Article in English | MEDLINE | ID: mdl-20502417

ABSTRACT

This study evaluated the feasibility of open infrarenal abdominal aortic aneurysm (AAA) surgery under peridural and spinal anesthesia (vigil patient) alone in high-risk patients with severe chronic obstructive pulmonary disease (COPD) ineligible for endovascular aneurysm repair (EVAR) or open surgery in general anesthesia. Between January 2005 and July 2007, seven patients underwent open AAA surgery with combined spinal and epidural anesthesia ([CSEA] without intubation) alone. Regional abdominal anesthesia was established by spinal anesthesia at L2-3 (levobupivacaine plus fentanyl) associated with peridural anesthesia at T7-8 (levobupivacaine). In this series (6 males and 1 female) the average age was 76.5 years (70-87); the AAA measured 7 cm in diameter on average (range 6-12.2). The survival rate was 100% (7/7 patients) at 6-12 months postoperative; no morbidities occurred during the postoperative phase. Owing to the small size of the series, no statistically significant conclusions can be drawn; even so, repair surgery was found to be effective, without the occurrence of morbidities or mortalities. In high-risk patients (severe COPD), open surgical repair of infrarenal AAA may be done with CSEA alone without intubation when, because of the patient's health, general anesthesia would pose too high a risk or when EVAR is unfeasible. Furthermore, the authors believe that surgical AAA repair under CSEA in vigil patients is a valid treatment option in those subjects with a high operative risk (severe COPD) and untreatable by either open AAA surgery under general anesthesia or EVAR.


Subject(s)
Adjuvants, Anesthesia , Anesthesia, Epidural , Anesthesia, Spinal , Anesthetics, Local , Aortic Aneurysm, Abdominal/surgery , Pulmonary Disease, Chronic Obstructive/complications , Vascular Surgical Procedures , Aged , Aged, 80 and over , Anesthesia, Epidural/adverse effects , Anesthesia, Spinal/adverse effects , Aortic Aneurysm, Abdominal/complications , Aortic Aneurysm, Abdominal/diagnostic imaging , Aortography/methods , Bupivacaine/analogs & derivatives , Feasibility Studies , Female , Fentanyl , Humans , Italy , Levobupivacaine , Male , Severity of Illness Index , Time Factors , Tomography, X-Ray Computed , Treatment Outcome , Vascular Surgical Procedures/adverse effects
SELECTION OF CITATIONS
SEARCH DETAIL
...