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To compare general, epidural and local anaesthesia for endovascular aneurysm repair (EVAR)
D A Bettex1, M Lachat, T Pfammatter
1Division of Cardiovascular Anaesthesia, Institute of Anaesthesia, University Hospital of Zurich, Zurich, CH-8091, Switzerland.
Objectives:
to compare general, epidural and local anaesthesia for endovascular aneurysm repair (EVAR).
Methods:
retrospective analysis of 91 consecutive patients (age 43 to 89 years) who underwent EVAR under local (LA, 63 patients), epidural (EDA, 8 patients) and general (GA, 20 patients) anaesthesia.
Results:
EVAR was successfully achieved in all patients without mortality or neurological, cardiac and respiratory complications. Vasopressive support as well as median fluid balance were significantly lessened in the LA group compared to GA group (p<0.0002). Stay in the Intensive Care Unit was necessary in 17 (27%), four (50%) and 14 (70%) patients, respectively, and median hospital stay was 3, 4.5, and 5.5 days, with a statistically significant difference between LA and GA group (p<0.0005).
Conclusion:
LA is a safe anaesthetic method for the endovascular repair of infrarenal abdominal aneurysm, offering several advantages: simplicity, stable haemodynamics, and reduced consumption of ICU and hospital beds.