Anesthetic management of endovascular repair for aortic abdominal aneurysm in a patient with severe chronic obstructive pulmonary disease

Shigekazu Sugino, Keiichi Omote, Mikito Kawamata, Akiyoshi Namiki

Research output: Contribution to journalArticlepeer-review

Abstract

A 66-year-old man with severe chronic obstructive pulmonary disease (COPD) was scheduled for elective endovascular repair of an aortic abdominal aneurysm and femoral-femoral artery bypass. Because spirometry revealed marked reduction of percent forced expiratory volume in 1 second (% FEV1.0), postoperative respiratory failure was anticipated. Spinal anesthesia and no use of tracheal intubation were planned. When the patient entered the operating room, his oxygen saturation (SpO2) was 92%. Four ml of isobaric 0.5% bupivacaine was injected intrathecally at the L3-4 inter-space using a 25-gauge spinal needle. After the final analgesic level of the spinal anesthesia had been ensured at T6, 1.0% lidocaine 5 ml was injected intradermally in the right elbow for insertion of a catheter sheath. Additional analgesia was acquired with a total of 0.1 mg of fentanyl IV. The endovascular repair was completed uneventfully. In conclusion, spinal anesthesia combined with local anesthesia in the elbow is useful for management of endovascular repair of an aortic abdominal aneurysm in patients with severe COPD for whom postoperative respiratory failure is anticipated.

Original languageEnglish
Pages (from-to)1480-1483
Number of pages4
JournalJapanese Journal of Anesthesiology
Volume55
Issue number12
Publication statusPublished - 2006 Dec 1
Externally publishedYes

Keywords

  • Aortic abdominal aneurysm
  • Endovascular repair and chronic obstructive pulmonary disease

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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