Our experience suggested that hospital stay and morbidity after abdominal aortic surgery can be decreased by performing a mininvasive surgical approach, thoracic epidural anesthesia-analgesia and an aggressive postoperative nursing on the ward. Therefore, this multidisciplinary program can be proposed to all patients undergoing aortic surgery without prior selection, major technological investments and long-term surveillance.
A greater number of people with spinal cord injury is always submitted to surgical operations. Some pathologies associated to the medullary damage as the autonomic dysreflexia, the muscular spasm and the respiratory inadequacy can increase perioperative complications. Manifold early studies have shown that the multimodal approach in complex elective surgery can reduce perioperative morbility and mortality.We describe the case of a 77 year-old patient tetraparetic scheduled for open abdominal aortic aneurismectomy using multimodal approach that consists in minimal invasive surgery (subcostal incision), thoracic epidural anesthesia with light sedation and postoperative forced rehabilitation. This approach has allowed the decrease of perioperatorie complications and the improvement of postoperative outcome.
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