Masui. The Japanese journal of anesthesiology
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The endovascular repair of thoracic aortic aneurysm and abdominal aortic aneurysm has become a promising alternative for open surgical graft replacement. The benefits of EVAR include less invasiveness, no need for cardiopulmonary bypass or differential lung ventilation, less blood loss, shorter hospital stay and reduced perioperative morbidity and mortality. ⋯ Previous abdominal aortic aneurysm repair, prolonged hypotension, severe atherosclerosis of the thoracic aorta, injury to the external iliac artery, and more extensive coverage of the thoracic aorta by the graft are reported to be the risk factors for paraplegia after TEVAR. In such cases, strategies to protect the spinal cord from ischemia including lumbar cerebrospinal fluid drainage should be taken.
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Clinical Trial
[Effectiveness of underbody type forced-air warming blanket during endovascular aneurysm repair].
Intraoperative hypothermia is frequently observed during endovascular aneurysm repair (EVAR), leading to postoperative serious sequelae. We evaluated the effectiveness of underbody type forced-air warming blanket against hypothermia during EVAR. ⋯ Underbody type forced-air warming blanket is effective to prevent intraoperative hypothermia during EVAR.
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Anaphylaxis during anesthesia is a rare but life-threatening event. Sugammadex is a recently introduced drug that was specifically designed for the reversal of rocuroium and vecuronium-induced neuromuscular block. ⋯ Initial management consisted of fluid administration and intermittent i.v. ephedrine, epinephrine, and hydrocortisone. The patients made uncomplicated recovery and were discharged.