Mehmet Salih AYDIN, Aydemir KOÇARSLAN, Abdussemet HAZAR, Ahmet KÜÇÜK, Mustafa GÖZ, Mert ÜRKÜP

İnfrarenal ve Torasik Abdominal Aort Anevrizmalarına Lokal Anestezi ile Sedasyon Altında Endovasküler Anevrizma Onarımı

Amaç: Bu çalışmanın amacı infrarenal aort anevrizma ve torasik aort anevrizmalı hastalarda lokal anestezi ile sedasyon eşliğinde endovasküler anevrizma tamiri deneyiminin raporlanmasıdır. Materyal ve Metod: Temmuz 2011 ve temmuz 2013 arsında 8 hasta departmanımızda lokal anestezi ve kontrollü sedasyon eşliğinde endovasküler anevrizma tamiri uygulandı. Lokal anestezi 2% Prilokain infiltrasyonu ile sağlandı ve sedasyon ise intravenöz midazolam 0.05 - 0.2 mg/kg IV, fentanyl 50-150 microgram IV bolus, and propofol 25-75 microgram /kg bolus ile temin edildi. Bulgular: Endovasküler anevrizma tamiri 6 infrarenal aort anevrizması ve 2 torasik aort anevrizması hastalarına uygulandı. Mortalite veya major postoperatif morbidite kaydedilmedi ve işlem sonrası ortlama hastanede kalış süresi 3,2 gün ( 2-5 gün) idi. Bütün hastaların bir yıllık takiplerinde mortalite veya rekürrens izlenmedi. Sonuç: Endovasküler anevrizma tamiri kritik hastalarda güvenli prosedürdür ve kolaylıkla lokal anestezi ve sedasyon altında uygulanabilir. Bu prosedürde lokal anestezi ile sedasyon anestezi yönetiminde bir alternatif olabilir.

Anahtar Kelimeler:

Aort anevrizması, Endovasküler Prosedürler, Lokal anestezi, Sedasyon

Endovascular Aneurysm Repair for Infra-renal and Thoracic Abdominal Aort Aneurysms Under Local Anesthesia with Sedation

Background: This study aims to report our experience of endovascular aneurysm repair with LA and sedation in patients with infra-renal aortic aneurysm and thoracic aorta aneurysm. Materials and Methods: Between July 2011 and July 2013, 8 patients underwent endovascular aneurysm repair with local anesthesia and controlled sedation in our department. Local anesthesia was achieved by infiltrating 2% Prilocain and for the sedation was provided by intravenous midazolam 0.05 - 0.2 mg/kg IV, fentanyl 50-150 microgram IV bolus, and propofol 25-75 microgram /kg bolus. Results: Endovascular aneurysm repair was used in six patients infra-renal aortic aneurysm and two patients thoracic aorta aneurysm. No mortality or major post operative morbidity was recorded and the mean hospital stay post procedure was 3.2 days (range 2-5 days). One year follow-up all patient no mortality or recurrence was observed. Conclusion: Endovascular aneurysm repair are safe procedure in critical patient and easily done under local anesthesia and sedation. LA with sedation in this procedure might be an alternative in anesthetic management.

Keywords:

Aortic Aneurysm, Endovascular Procedures, Local anesthesia, Sedation,

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