Abstract

Objectives: This study aimed to compare the perioperative and postoperative outcomes of elective endovascular abdominal aortic aneurysm repair (EVAR) under general anesthesia (GA) and local anesthesia (LA).

Materials and Methods: This retrospective study included 96 patients who underwent elective EVAR at a single center. The patients were divided into two groups based on the type of anesthesia administered: 48 patients in the GA group and 48 patients in the LA group. Data on demographic characteristics, perioperative factors (such as operation time, blood loss, and contrast volume), and postoperative outcomes (including intensive care unit stay, hospital stay, and complications) were collected and compared between the two groups. The primary focus was on evaluating differences in the operative time, length of hospital stay, and incidence of postoperative complications between the GA and LA.

Results: The total operation time was shorter in the LA group (124.1±22.7 minutes) than in the GA group (136.2±35.3 minutes, p=0.041). The LA group also exhibited significantly lower blood loss (139.5±11.2 mL vs. 181.9±5.1 mL, p<0.001) and used less contrast volume (86.9±19.6 mL vs. 123.0±26.6 mL, p<0.001). Pulmonary complications were more frequent in the GA group (54.2% vs. 10.4%, p<0.001), whereas the LA group had a higher percentage of patients with no complications (50.0% vs. 20.8%, p=0.003). The length of hospital stay was also shorter in the LA group (4.7±0.8 days) than in the GA group (8.7±4.4 days, p<0.001).

Conclusion: LA during EVAR offers significant advantages over GA, including reduced pulmonary complications, shorter operation times, and a shorter length of hospital stay. These findings suggest that LA is a safer and more efficient option for patients undergoing EVAR, particularly those at high risk of pulmonary complications. Further prospective studies are necessary to confirm these results and to guide anesthesia management strategies for EVAR.