Original Articles

Annals of Vascular Surgery

, Volume 3, Issue 3, pp 214-219

First online:

Neuroleptanesthesia versus thoracic epidural anesthesia for abdominal aortic surgery

  • F. BonnetAffiliated withDepartment of Anesthesia, Hôpital Henri MondorDepartment of Intensive Care, Hôpital Henri MondorDepartment of Vascular Surgery, Hôpital Henri Mondor
  • , C. TouboulAffiliated withDepartment of Anesthesia, Hôpital Henri MondorDepartment of Intensive Care, Hôpital Henri MondorDepartment of Vascular Surgery, Hôpital Henri Mondor
  • , A. M. PicardAffiliated withDepartment of Anesthesia, Hôpital Henri MondorDepartment of Intensive Care, Hôpital Henri MondorDepartment of Vascular Surgery, Hôpital Henri Mondor
  • , J. VodinhAffiliated withDepartment of Anesthesia, Hôpital Henri MondorDepartment of Intensive Care, Hôpital Henri MondorDepartment of Vascular Surgery, Hôpital Henri Mondor
  • , J-P. BecqueminAffiliated withDepartment of Anesthesia, Hôpital Henri MondorDepartment of Intensive Care, Hôpital Henri MondorDepartment of Vascular Surgery, Hôpital Henri Mondor

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Abstract

The hemodynamic consequences of abdominal aortic surgery with infrarenal crossclamping were studied in 21 patients randomized in two groups. In Group I (11 patients), neuroleptanesthesia was utilized, while Group II (10 patients) received thoracic epidural anesthesia at the T8-9 level. Hemodynamic measurements were performed using Swan-Ganz catheters during the surgical procedures in all patients, with special attention to the periods of clamping and unclamping of the abdominal aorta. The thoracic epidural anesthesia group was characterized by greater hemodynamic stability during surgery, while patients in the neuroleptanesthesia group had significant lability of blood pressure, heart rate, and cardiac index. Nevertheless, in the two groups of patients, it is suggested that cardiac function was unfitted to the tissue oxygen demand after unclamping of the aortic prosthesis because the saturation in oxygen of the mixed venous blood and an increase in arteriovenous difference in oxygen were documented. These results point out that, whatever the anesthesia technique, the critical period in abdominal surgery could be aortic unclamping.

Key words

Neuroleptanesthesia anesthesia abdominal aorta