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Spinal anesthesia for endoluminal abdominal aortic aneurysm repair
1Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.
Study Objective:
To determine whether spinal anesthesia can be safely used for patients under endoluminal abdominal aortic aneurysm (AAA) repair.
Design:
Retrospective chart review.
Setting:
University hospital.
Participants:
38 patients who underwent endoluminal AAA repair from 1999 to 2000.
Measurements And Main Results:
The charts of 38 patients who underwent endoluminal AAA repair from 1999 to 2000 were reviewed for variables known to be associated with AAA repair. Twenty-four patients had spinal anesthesia (63%), 13 patients had general anesthesia (35%), 1 patient had epidural anesthesia (2%). Eight patients (33%) in the spinal group eventually had to have general anesthesia. Reasons included prolonged procedure in six cases and patient intolerance and anxiety in two cases.
Conclusion:
Endoluminal AAA repair can be safely performed with spinal anesthesia. The major disadvantage of spinal anesthesia is limited duration of anesthesia. The anesthesia team must be prepared to induce general anesthesia at any time. The decision regarding anesthetic technique should focus on patient and physician needs and preferences.