General anesthesia versus sedation with dexmedetomidine for thoracic endovascular aortic repair in 38 patients in multicenter experiences: A retrospective study

Choi, Hey Ran; Lee, Dae Won; Kim, Kyung Woo; Bang, Si Ra; Min, Sun Kyung; Oh, Min Kyung; Kim, Ji Yeon; Ro, Young Jin; Choi, Yoon Ji

Clinical Research

Cardiothoracic and Vascular Anesthesia

Anesthesia and Pain Medicine 2014;9(3):193-200.
Published online July 31, 2014.

General anesthesia versus sedation with dexmedetomidine for thoracic endovascular aortic repair in 38 patients in multicenter experiences: A retrospective study

Hey Ran Choi, Dae Won Lee, Kyung Woo Kim, Si Ra Bang, Sun Kyung Min, Min Kyung Oh, Ji Yeon Kim, Young Jin Ro, Yoon Ji Choi

¹Department of Anesthesiology and Pain Medicine, Seoul Paik Hospital, Inje University, Seoul, Korea. yoonji07@gmail.com
²Department of Thoracic and Cardiovascular Surgery, Seoul Paik Hospital, Inje University, Seoul, Korea.
³Department of Pharmacology, Busan Paik Hospital, Inje University, Busan, Korea.
⁴Department of Anesthesiology and Pain Medicine, Ilsan Paik Hospital, Inje University, Goyang, Korea.
⁵Department of Anesthesiology and Pain Medicine, Asan Medical Center, Seoul, Korea.

Received: 25 November 2013 • Revised: 20 March 2014

Abstract

BACKGROUND
Endovascular stent graft placement is a useful treatment option in lesions of the thoracic aorta. The aim of this study was to assess the possibility of sedation with dexmedetomidine compared with general anesthesia in patients undergoing thoracic endovascular aortic repair (TEVAR) in a multi-center clinical trial.
METHODS
Data from 38 patients with thoracic aorta lesions treated by TEVAR between April 2010 and November 2013 were retrospectively collected at two hospitals. General anesthesia or sedation with dexmedetomidine was determined according to the hospital. Demographics, anesthetic recordings, and complications were reviewed.
RESULTS
Stent graft placement was technically successful in all patients. There were no events during the anesthetic period. A total of 38 patients underwent TEVAR; 29 patients received general anesthesia, and 9 received sedation. Dexmedetomidine sedation (loading dose: 0.5-1.0 microg/kg for 10 min, maintenance: 0.2-0.8 microg/kg/h) was successfully performed without anesthesia-related complications or mortality. During the procedure, mean arterial pressure, heart rate, and saturation of peripheral oxygen were not statistically different between general anesthesia and dexmedetomidine sedation.
CONCLUSIONS
In our study, TEVAR under sedation with dexmedetomidine was shown to be a feasible procedure that was well tolerated without specific complications.

Key Words: General anesthesia, Morbidity, Mortality, Sedation, Thoracic endovascular aortic repair