{"title":"腹主动脉瘤血管内修复术围手术期结果的比较分析:髂筋膜阻滞与全身麻醉的回顾性研究。","authors":"Surakiat Bokerd, Veera Suwanruangsri, Wanchai Chinchalongporn, Virapat Chanchitsopon","doi":"10.1177/17085381241273306","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This retrospective study aimed to compare rates of perioperative mortality and morbidity, especially pulmonary complication, between endovascular aneurysm repair (EVAR) performed under general anesthesia (GA) and under fascia iliaca block (FIB).</p><p><strong>Methods: </strong>Patients diagnosed with infrarenal abdominal aortic aneurysm (AAA) who were treated with EVAR were included. Retrospective review of electronic medical records was performed. Patient characteristics, operative details, and postoperative results including mortality and morbidity within 30 days were collected. Statistical analysis to compare postoperative outcomes between EVAR under FIB and EVAR under GA was performed. A univariate analysis was conducted to identify factors associated with increased 30-day mortality.</p><p><strong>Results: </strong>This study included 119 patients, 75 in the FIB group and 44 in the GA group. Most patients were male, with 62 (82.5%) in the FIB group and 31 (70.2%) in the GA group, and most patients were hypertensive, with 57 (76%) in the FIB group and 36 (81.8%) in the GA group. Smoking and coronary artery disease (CAD) was more prevalent in the FIB group, <i>p</i> < .05. Thirty-day mortality was not significantly different between the FIB group and the GA group (1 (1.3%) vs 2 (4.5%), <i>p</i> = .554). Pulmonary complication was lower in the FIB group than in the GA group (1.3% vs 11.4%, <i>p</i> = .026). ICU stay was shorter in the FIB group than in the GA group (0.2 vs 4.5 days, <i>p</i> = .012). Univariate analysis showed that chronic obstructive pulmonary disease (COPD) was associated with higher 30-day mortality.</p><p><strong>Conclusions: </strong>Endovascular aneurysm repair under FIB was feasible. Compared to GA, this approach resulted in lower postoperative pulmonary complications and shorter ICU stay.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparative analysis of perioperative outcomes in endovascular abdominal aortic aneurysm repair: Fascia iliaca block versus general anesthesia, a retrospective study.\",\"authors\":\"Surakiat Bokerd, Veera Suwanruangsri, Wanchai Chinchalongporn, Virapat Chanchitsopon\",\"doi\":\"10.1177/17085381241273306\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This retrospective study aimed to compare rates of perioperative mortality and morbidity, especially pulmonary complication, between endovascular aneurysm repair (EVAR) performed under general anesthesia (GA) and under fascia iliaca block (FIB).</p><p><strong>Methods: </strong>Patients diagnosed with infrarenal abdominal aortic aneurysm (AAA) who were treated with EVAR were included. Retrospective review of electronic medical records was performed. Patient characteristics, operative details, and postoperative results including mortality and morbidity within 30 days were collected. Statistical analysis to compare postoperative outcomes between EVAR under FIB and EVAR under GA was performed. A univariate analysis was conducted to identify factors associated with increased 30-day mortality.</p><p><strong>Results: </strong>This study included 119 patients, 75 in the FIB group and 44 in the GA group. Most patients were male, with 62 (82.5%) in the FIB group and 31 (70.2%) in the GA group, and most patients were hypertensive, with 57 (76%) in the FIB group and 36 (81.8%) in the GA group. Smoking and coronary artery disease (CAD) was more prevalent in the FIB group, <i>p</i> < .05. Thirty-day mortality was not significantly different between the FIB group and the GA group (1 (1.3%) vs 2 (4.5%), <i>p</i> = .554). Pulmonary complication was lower in the FIB group than in the GA group (1.3% vs 11.4%, <i>p</i> = .026). ICU stay was shorter in the FIB group than in the GA group (0.2 vs 4.5 days, <i>p</i> = .012). Univariate analysis showed that chronic obstructive pulmonary disease (COPD) was associated with higher 30-day mortality.</p><p><strong>Conclusions: </strong>Endovascular aneurysm repair under FIB was feasible. Compared to GA, this approach resulted in lower postoperative pulmonary complications and shorter ICU stay.</p>\",\"PeriodicalId\":23549,\"journal\":{\"name\":\"Vascular\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2024-08-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Vascular\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/17085381241273306\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Vascular","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17085381241273306","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0
摘要
目的:这项回顾性研究旨在比较在全身麻醉(GA)下和髂筋膜阻滞(FIB)下进行血管内动脉瘤修补术(EVAR)的围术期死亡率和发病率,尤其是肺部并发症:方法:纳入诊断为肾下腹主动脉瘤(AAA)并接受EVAR治疗的患者。对电子病历进行回顾性分析。收集了患者特征、手术细节和术后结果,包括30天内的死亡率和发病率。对 FIB 下 EVAR 和 GA 下 EVAR 的术后结果进行了统计分析比较。进行了单变量分析,以确定与 30 天死亡率增加相关的因素:本研究共纳入 119 例患者,其中 FIB 组 75 例,GA 组 44 例。大多数患者为男性,其中 FIB 组 62 人(82.5%),GA 组 31 人(70.2%);大多数患者为高血压患者,其中 FIB 组 57 人(76%),GA 组 36 人(81.8%)。FIB 组吸烟和冠状动脉疾病 (CAD) 的发病率更高,P < .05。FIB 组和 GA 组的 30 天死亡率无明显差异(1 (1.3%) vs 2 (4.5%),P = .554)。FIB 组的肺部并发症低于 GA 组(1.3% vs 11.4%,P = .026)。FIB 组的重症监护室住院时间短于 GA 组(0.2 天 vs 4.5 天,p = .012)。单变量分析显示,慢性阻塞性肺病(COPD)与较高的30天死亡率相关:结论:在FIB下进行血管内动脉瘤修复是可行的。与GA相比,这种方法可降低术后肺部并发症,缩短重症监护病房的住院时间。
Comparative analysis of perioperative outcomes in endovascular abdominal aortic aneurysm repair: Fascia iliaca block versus general anesthesia, a retrospective study.
Objective: This retrospective study aimed to compare rates of perioperative mortality and morbidity, especially pulmonary complication, between endovascular aneurysm repair (EVAR) performed under general anesthesia (GA) and under fascia iliaca block (FIB).
Methods: Patients diagnosed with infrarenal abdominal aortic aneurysm (AAA) who were treated with EVAR were included. Retrospective review of electronic medical records was performed. Patient characteristics, operative details, and postoperative results including mortality and morbidity within 30 days were collected. Statistical analysis to compare postoperative outcomes between EVAR under FIB and EVAR under GA was performed. A univariate analysis was conducted to identify factors associated with increased 30-day mortality.
Results: This study included 119 patients, 75 in the FIB group and 44 in the GA group. Most patients were male, with 62 (82.5%) in the FIB group and 31 (70.2%) in the GA group, and most patients were hypertensive, with 57 (76%) in the FIB group and 36 (81.8%) in the GA group. Smoking and coronary artery disease (CAD) was more prevalent in the FIB group, p < .05. Thirty-day mortality was not significantly different between the FIB group and the GA group (1 (1.3%) vs 2 (4.5%), p = .554). Pulmonary complication was lower in the FIB group than in the GA group (1.3% vs 11.4%, p = .026). ICU stay was shorter in the FIB group than in the GA group (0.2 vs 4.5 days, p = .012). Univariate analysis showed that chronic obstructive pulmonary disease (COPD) was associated with higher 30-day mortality.
Conclusions: Endovascular aneurysm repair under FIB was feasible. Compared to GA, this approach resulted in lower postoperative pulmonary complications and shorter ICU stay.
期刊介绍:
Vascular provides readers with new and unusual up-to-date articles and case reports focusing on vascular and endovascular topics. It is a highly international forum for the discussion and debate of all aspects of this distinct surgical specialty. It also features opinion pieces, literature reviews and controversial issues presented from various points of view.