GKD Anest Yoð Bak Dern Derg. 2015; 21(2): 95-100 | DOI: 10.5222/GKDAD.2015.095

Abdominal aortik anevrizma tamirinde kombine spinal epidural anestezi mi ya da lokal anestezi + sedoanaljezi mi?

Cavidan Arar¹, Ünal Sezen¹, Adnan Yüksek¹, Hatice Sarýkaya¹, Filiz Turan¹, Cüneyt Turan¹, Cengiz Mordeniz¹, Onur Baran¹, Mustafa Günkaya¹, Selami Gürkan², Özcan Gür², Gamze Saraçoðlu^3
1Namýk Kemal Üniversitesi Týp Fakültesi Anesteziyoloji Ve Reanimasyon Abd. Tekirdað
²Namýk Kemal Üniversitesi Týp Fakültesi Kardiyovasküler Cerrahi Abd. Tekirdað
³Namýk Kemal Üniversitesi Týp Fakültesi Halk Saðlýðý Abd. Tekirdað

AMAÇ: Abdominal aort anevrizmasý tamiri için farklý anestezi modaliteleri ya da kombinasyonlarý uygulanabilir. Geriatrik hastalarda eþlik eden patolojiler varlýðýndan dolayý mortalite ve morbidite riski artmýþtýr. Çalýþmamýz geriatrik hastalarda endovasküler anevrizma tamiri için seçilebilen iki farklý anestezi metodunu karþýlaþtýrmayý amaçlamýþtýr.
YÖNTEMLER: 16 yüksek riskli geriatrik hasta çalýþmaya dahil edildi. Elektif ya da acil olarak endovasküler anevrizma operasyonu olacak 16 yüksek riskli hastanýn parametreleri çalýþmada kullanýldý. Grup – I (n: 8)’e lokal anestezi ve sedasyon uygulanýrken, Grup – II’ye ise kombine spinal epidural anestezi uygulandý. Ýntraoperatif ve postoperatif hemodinamik parametreler gözlendi ve kayýt altýna alýndý. Ýki grubun demografik özellikleri birbirlerine uyumlu idi.
BULGULAR: Komplikasyon oraný ortalama olarak %6,25 ve anlamlý olarak bulunmadý (p>0,05). Hastanede ve yoðun bakýmda kalma oranýnda ise iki grup arasýnda ise önemli bir fark bulunmadý (p>0,05).
SONUÇ: Kombine spinal ve epidural anestezi daha çok tecrübe gerektirir ama lokal anestezi ve sedasyondan endovasküler aort anevrizmasý hastalarý için daha güvenlidir.

Anahtar Kelimeler: Abdominal aort anevrizmasý, endovasküler cerrahi, yüksek kardiyak risk, kombine spinal epidural anestezi, lokal anestezi

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Combined spinal-epidural anesthesia or local anesthesia + sedoanalgesia in abdominal aortic aneurism repair?

Cavidan Arar¹, Ünal Sezen¹, Adnan Yüksek¹, Hatice Sarýkaya¹, Filiz Turan¹, Cüneyt Turan¹, Cengiz Mordeniz¹, Onur Baran¹, Mustafa Günkaya¹, Selami Gürkan², Özcan Gür², Gamze Saraçoðlu^3
1Namik Kemal University Department Of Anesthesiologhy And Reanimation. Tekirdag
²Namik Kemal University Department Of Cardiovascular Surgery. Tekirdag
³Namýk Kemal University Department Of Public Health. Tekirdag

OBJECTIVE: Anesthesia for the repair of abdominal aortic aneurism can be performed with different modalities of anesthesia or their combinations. The risk level for the morbidity and mortality of the patients, is increased in geriatric patients with the existence of accompanying pathology. To compare two different anesthesia methods (local anesthesia and sedation vs combined spinal and epidural anesthesia) for the repair of endovascular aneurism in a geriatric patient.
METHODS: 16 high risk geriatric patients were included in the study. The parameters of 16 high risk patients who underwent elective or emergency treatment for endovascular aneurism were included. Group-I (n: 8) was given local anesthesia and sedation, Group-II (n: 8) was given combined spinal and epidural anesthesia. Intraoperative and postoperative hemodynamic parameters were reviewed and analyzed. The demographic data of the two groups ressembled each other.
RESULTS: The complication rate was calculated at an average of 6.25%, which was considered insignificant (p> 0.05). There was no significant difference between the duration of hospital and intensive care unit stay for the two groups (p> 0.05).
CONCLUSION: Combined spinal and epidural anesthesia requires much more experience, but it is safer than local anesthesia and sedation for endovascular aneurism patients.

Keywords: Abdominal aort aneurism, endovasculary surgery, high cardiac risk, combined spinal epidurally anesthesia, local anesthesia

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