Use of Dexmedetomidine Versus General Anesthesia for Endovascular Repair of Abdominal Aortic Aneurysms

Abstract

While abdominal aortic aneurysms have traditionally been treated with a major open surgical procedure, minimally invasive endovascular techniques are much less traumatic, with significantly less strain on the heart and vital organs. A sedation technique using dexmedetomidine, an alpha 2-adrenoreceptor agonist, was developed for this procedure. We retrospectively reviewed records of 231 patients who underwent endovascular repair of abdominal aortic aneurysms at the Baylor Jack and Jane Hamilton Heart and Vascular Hospital from January 1, 2001, until September 30, 2005. Intraoperative and early postoperative data of 14 patients who had endovascular repairs using the dexmedetomidine sedation technique were compared with those of 22 patients who received general endotracheal tube anesthesia for the procedure during the time period of January 1, 2003, through September 1, 2005. The surgery and anesthesia times were shorter in the dexmedetomidine group, and less opioid medication was required. In addition, the postoperative pain scores were lower, and the need for postoperative pain medication was less in the dexmedetomidine group. This retrospective analysis demonstrates that a dexmedetomidine sedation technique offers a successful alternative to routine general anesthesia for endovascular repair of abdominal aortic aneurysms.