Anesthetic management of abdominal aortic aneurysm surgery

Abstract

The analysis of anesthetic management, intraoperative infusion and the postoperative period is presented on the example of 105 patients operated on for abdominal aortic aneurysm in the period from 2013 to 2018. It is concluded that the isolated regional anesthesia prevails in the studied group of patients. This is due to the predominance of the “closed” method among the conducted operations — endovascular aneurysm repair (EVAR). Most of the “open” surgical interventions were performed under combined anesthesia. During 5 years of analysis, the volume of intraoperative infusion therapy decreased. In 2013–2015, hemo­ and plasma­transfusion was performed in 60–100 % of cases, whereas in 2016–2018 — only in 20 %. The same applies to colloidal solutions. This is associated with reduced duration of surgery and a decrease in the volume of intraoperative blood loss. Patients whose regional component was present in the anesthetic management, on average, spent less time in reanimation. Due to prolonged epidural analgesia, the restoration of all body functions and activation occurred earlier than with analgesia narcotic analgesics. The time of hospitalization for patients who underwent EVAR are two times less than the time of hospitalization of patients who underwent “open” surgery. The highest percentage of complications is in the group of patients who have undergone “open” surgical interventions.