Yağan Özgür, Özyılmaz Kadir, Taş Nilay, Hancı Volkan
Department of Anaesthesiology and Reanimation, Ordu University Faculty of Medicine, Ordu, Turkey.
Clinic of Anaesthesiology and Reanimation, Ordu State Hospital, Ordu, Turkey.
Turk J Anaesthesiol Reanim. 2015 Feb;43(1):35-40. doi: 10.5152/TJAR.2014.47450. Epub 2014 Sep 9.
The aim of this study is to compare general anaesthesia (GA) versus regional anaesthesia (RA) for endovascular aneurysm repair (EVAR).
We analysed the files of 89 patients between August 2010-August 2012 who underwent elective EVAR retrospectively.
We performed RA for 32 patients (36%) and GA for 57 patients (64%). The operations were completed successfully in both groups and did not require conventional surgery. The mean age of the patients was 71.5±7 (range 50-88 years). RA was preferred more than GA in the presence of advanced-stage chronic obstructive pulmonary disease statistically (p=0.032). The usage of vasodilator drug and atropine was found to be higher in the GA group than the RA group in the intraoperative period (p=0.001 and p=0.01, respectively). The intensive care unit (ICU) was necessary for 5 patients in the RA group (16%) and 13 patients for the GA group (23%) postoperatively (p=0.301). The median ICU stay in the RA group was 2 hours and 4.4 hours in the GA group (p=0.114). The median hospital stay was 2.63±1.91 days in the RA group and 2.04±1.16 days in the GA group, with no statistically significant difference between groups (p=0.120). There was no mortality of patients in either group for the peroperative period and the 30-day follow-up period.
Our present study suggests that patient characteristics are more important than the anaesthetic method on the outcomes of EVAR.
本研究旨在比较全身麻醉（GA）与区域麻醉（RA）用于血管内动脉瘤修复术（EVAR）的效果。
我们回顾性分析了2010年8月至2012年8月期间89例行择期EVAR手术患者的病历。
我们对32例患者（36%）实施了RA，对57例患者（64%）实施了GA。两组手术均成功完成，无需进行传统手术。患者的平均年龄为71.5±7岁（范围50 - 88岁）。在晚期慢性阻塞性肺疾病患者中，RA的选择率在统计学上高于GA（p = 0.032）。术中发现GA组血管扩张剂药物和阿托品的使用量高于RA组（分别为p = 0.001和p = 0.01）。术后RA组有5例患者（16%）需要入住重症监护病房（ICU），GA组有13例患者（23%）需要入住（p = 0.301）。RA组ICU中位住院时间为2小时，GA组为4.4小时（p = 0.114）。RA组中位住院时间为2.63±1.91天，GA组为2.04±1.16天，两组间无统计学显著差异（p = 0.120）。两组患者在手术期和30天随访期均无死亡病例。
我们目前的研究表明，对于EVAR的手术效果，患者特征比麻醉方法更重要。
