Local plus sedoanalgesia or spinal analgesia in endovascular aortic aneurysm repair experiences in a single center

Abstract

Aim: In this study, we aimed to discuss the local anesthesia plus sedoanalgesia (LA-SA) and spinal anesthesia methods applied during endovascular aortic repair (EVAR) by retrospectively comparing the patients' data. Material and Method: This study was carried out by retrospectively evaluating the data of 36 patients, who underwent endovascular surgery for aortic aneurysm, between 1 January 2013 and 31 December 2018. Three cases who were applied general anesthesia were not included in the study.The patients included in the study were divided into two groups according to the anesthesia method as LA-SA group (Group 1, n=19) and spinal anesthesia group (Group 2, n=14). This study was planned as a retrospective observational comparative study. Demographic data, comorbidities, American Anesthesiologists Association (ASA) risk classification scores, mortality rates, duration of anesthesia and surgery, length of stay in the hospital and intensive care unit, and laboratory values were analyzed. Results: In current study, the mean age of 33 patients who underwent EVAR procedure was 69.04±13 (32-86). Local anesthesia plus sedo-analgesia was applied to 19 (52.7%) patients and spinal anesthesia was applied to 14 (38.8%) patients. No significant difference was found between demographic data, comorbidities and smoking rates in both groups. The length of stay in the hospital and the intensive care unit and the rates of death before discharge were similar in both groups (p=0.22), (p=0.15), (p=0.73), Anesthesia and operation times were shorter in the local anesthesia plus sedoanalgesia group compared to the spinal anesthesia group (p = 0.00, p = 0.004, respectively). Laboratory examinations of both groups were similar. Conclusion: For arterial stents requiring percutaneous implantation, LA-SA provides a safe anesthesia method with stable hemodynamics, less invasive intervention and shorter operation times than neuraxial anesthesia.