To Compare General, Epidural and Local Anaesthesia for Endovascular Aneurysm Repair (EVAR)

Eur J Vasc Endovasc Surg 21, 179–184 (2001) doi:10.1053/ejvs.2000.1295, available online at http://www.idealibrary.com on

To Compare General, Epidural and Local Anaesthesia for Endovascular Aneurysm Repair (EVAR) D. A. Bettex∗1, M. Lachat2, T. Pfammatter3, D. Schmidlin1, M. I. Turina2 and E. R. Schmid1 1

Division of Cardiovascular Anaesthesia, Institute of Anaesthesia, University Hospital of Zurich, Department of Cardiovascular Surgery, University Hospital of Zurich, and 3Department of Radiology, University Hospital of Zurich, CH-8091 Zurich, Switzerland

2

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 (p1 bolus vasopressors

LA (63)

EDA (8)

GA (20)

Total (91)

90 (±2.2)†, § 10 (15.9%) 1 4.5 (±0.8) 3 (±0.6) +1000 (±147)∗, § 1.7 (±0.7) 95.5 (±0.8) 44 (69%) 10 (16%)‡,∗, § 5 (8%)

82 (±8) 1 (12.5%) 0 5.0 (±1.5) 4 (±1.3) +1460 (±446) 1.8 (±0.5) 93 (±2.4) 5 (63%) 6 (75%) 2 (25%)

78 (±2.8) 7 (35%) 0 5.5 (±1.8) 5 (±1.9) +1950 (±590) 1.6 (±1) 95.5 (±4) 14 (70%) 12 (60%) 10 (50%)

85 (±2) 18 (19.7%) 1 (1%) 5.0 (±0.7) 4 (±0.7) +1245 (±202) 1.7 (±0.6) 95 (±0.8) 63 (69%) 28 (31%) 17 (19%)

Values are expressed as number of patients (%) or median±2SE (95% confidence interval). The conversions from EDA or LA to GA are included in the GA group. MAP: mean arterial pressure; HR: heart rate; CVP: central venous pressure; O2Sat: oxygen saturation. † LA versus GA and EDA: p