title: Paravertebral blockade with propofol sedation versus general anesthesia for elective endovascular abdominal aortic aneurysm repair.
abstract: The objective of this study was to evaluate the applicability of paravertebral blockade (PVB) for endovascular abdominal aortic aneurysm repair compared with general anesthesia (GA). Data from patients who underwent elective infrarenal endovascular abdominal aortic aneurysm repair between August 2001 and July 2002 using PVB or GA were retrospectively reviewed and compared with respect to risk factors, intraoperative hemodynamic characteristics, operative outcome, and complications. Ten patients underwent elective infrarenal endovascular abdominal aortic aneurysm repair under PVB, whereas 15 patients were operated on under GA. One conversion from PVB to GA was necessary for block failure. The perioperative (< 30 days) cardiovascular morbidity and overall mortality were zero in both groups. The PVB group benefited significantly with respect to the incidence of intraoperative hypotension (p < .05) and blood pressure lability (p < .01), as well as postoperative nausea (p < .01). Our preliminary results indicate that PVB is feasible and can be performed safely in a patient population with significant comorbidities.
authors.affiliation: Section of Vascular Surgery, Mayo Clinic Jacksonville, Jacksonville, FL, USA.
authors.forename: Juergen
authors.initials: J
authors.lastname: Falkensammer
authors.forename: Albert G
authors.initials: AG
authors.lastname: Hakaim
authors.forename: Josef
authors.initials: J
authors.lastname: Klocker
authors.forename: Matthias
authors.initials: M
authors.lastname: Biebl
authors.forename: Louis L
authors.initials: LL
authors.lastname: Lau
authors.forename: Beate
authors.initials: B
authors.lastname: Neuhauser
authors.forename: Monica
authors.initials: M
authors.lastname: Mordecai
authors.forename: Claudia
authors.initials: C
authors.lastname: Crawford
authors.forename: Roy
authors.initials: R
authors.lastname: Greengrass
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009407:Nerve Block / Q000379:methods*; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D015742:Propofol; D012189:Retrospective Studies
chemical_list: D015742:Propofol