Hormonal Stress Response and Hemodynamic Stability in Patients Undergoing Endovascular vs. Conventional Abdominal Aortic Aneurysm Repair
| Autor: | W. Chrapek, S. Kaukinen, J. Kataja, G. Pimenoff, J.-P. Salenius |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Mean arterial pressure Epinephrine Vasopressins Radioimmunoassay Renal function Hemodynamics 030204 cardiovascular system & hematology 030218 nuclear medicine & medical imaging Norepinephrine 03 medical and health sciences 0302 clinical medicine Aneurysm medicine Humans Lactic Acid Aged Aged 80 and over medicine.diagnostic_test business.industry Angiography Middle Aged Angioscopy medicine.disease Abdominal aortic aneurysm Surgery Treatment Outcome Anesthesia Anesthetic Female Tomography X-Ray Computed business Vascular Surgical Procedures Perfusion Biomarkers Aortic Aneurysm Abdominal medicine.drug |
| Zdroj: | Scandinavian Journal of Surgery. 96:236-242 |
| ISSN: | 1799-7267 1457-4969 |
| DOI: | 10.1177/145749690709600309 |
| Popis: | Background and Aims: To investigate the effect of two different surgical techniques with different anesthetic modes on intraoperative and postoperative hormonal stress response, hemodynamic stability, fluid loading and renal function in patients scheduled for elective infrarenal abdominal aortic aneurysm (AAA) repair. Materials and Methods: Forty consecutive patients scheduled for elective infrarenal AAA repair were allocated without randomizing into two groups: an endovascular (EVAR, n=20) and a conventional (CAR, n=20) aneurysm repair group according to aneurysm morphology as determined by pre-operative computed tomography and angiography. The EVAR group were operated under spinal anesthesia and the CAR group using general anesthesia with epidural blockade. Results: Patients undergoing CAR showed lower intraoperative mean arterial pressure and significantly higher plasma norepinephrine before aortic cross-clamping and significantly higher lactate after aortic declamping and postoperatively than patients in the EVAR group. Postoperatively, vasopressin and serum cortisol were also significantly higher in the CAR group. Fluid loading and estimated blood loss were more excessive in the CAR group. Conclusions: Stress response was lower and hemodynamic stability and lower body perfusion superior and renal function also better maintained in patients undergoing EVAR under spinal anesthesia as compared to those undergoing CAR using general anesthesia with epidural blockade. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|