OBJECTIVES: To compare changes in plasma catecholamines, acid-base status and cardiovascular dynamics in patients undergoing endovascular or conventional infrarenal abdominal aortic aneurysm (AAA) repair under standard general anaesthesia. DESIGN: Prospective cohort study. MATERIALS: 30 patients scheduled for elective infrarenal AAA repair. METHODS: Plasma epinephrine and norepinephrine concentrations, acid-base status and cardiovascular measurement were compared before surgery, and 5 min after aortic clamping and clamp release (conventional group) or occlusion and release (endovascular group) in patients undergoing endovascular (n = 15) or conventional AAA repair (n = 15). RESULTS: Arterial pH (p < 0.005) and base deficit (p < 0.05) increased, and plasma bicarbonate decreased (p < 0.005) during aortic cross-clamping in the conventional group. pH decreased further (p < 0.005), and base deficit and pCO2 increased (both p < 0.005) after clamp release. These changes were significantly greater than during endovascular repair, in whom within-group changes were not statistically significant. Values were similar in the two groups 30 min after reperfusion. Plasma epinephrine concentrations increased during conventional surgery (p < 0.05) and were greater than in the endovascular group (p < 0.05). Plasma norepinephrine concentrations increased during surgery in both groups but the changes were not statistically significant. CONCLUSIONS: Plasma catecholamine concentrations, changes in cardiovascular variables and acid-base status were increased during conventional compared with endovascular AAA repair.
OBJECTIVES: To compare changes in plasma catecholamines, acid-base status and cardiovascular dynamics in patients undergoing endovascular or conventional infrarenal abdominal aortic aneurysm (AAA) repair under standard general anaesthesia. DESIGN: Prospective cohort study. MATERIALS: 30 patients scheduled for elective infrarenal AAA repair. METHODS: Plasma epinephrine and norepinephrine concentrations, acid-base status and cardiovascular measurement were compared before surgery, and 5 min after aortic clamping and clamp release (conventional group) or occlusion and release (endovascular group) in patients undergoing endovascular (n = 15) or conventional AAA repair (n = 15). RESULTS: Arterial pH (p < 0.005) and base deficit (p < 0.05) increased, and plasma bicarbonate decreased (p < 0.005) during aortic cross-clamping in the conventional group. pH decreased further (p < 0.005), and base deficit and pCO2 increased (both p < 0.005) after clamp release. These changes were significantly greater than during endovascular repair, in whom within-group changes were not statistically significant. Values were similar in the two groups 30 min after reperfusion. Plasma epinephrine concentrations increased during conventional surgery (p < 0.05) and were greater than in the endovascular group (p < 0.05). Plasma norepinephrine concentrations increased during surgery in both groups but the changes were not statistically significant. CONCLUSIONS: Plasma catecholamine concentrations, changes in cardiovascular variables and acid-base status were increased during conventional compared with endovascular AAA repair.
Authors: Yifan Zhang; Katherine A Edmonds; Daniel J Raines; Brennan A Murphy; Hongwei Wu; Chuchu Guo; Elizabeth M Nolan; Michael S VanNieuwenhze; Anne-K Duhme-Klair; David P Giedroc Journal: J Mol Biol Date: 2020-08-11 Impact factor: 5.469
Authors: Demetrios N Moris; Michalis I Kontos; Eleftherios I Mantonakis; Antonios K Athanasiou; Eleftherios D Spartalis; Chris N Bakoyiannis; George P Chrousos; Sotirios E Georgopoulos Journal: Int J Clin Exp Med Date: 2014-09-15