Abstract:

Objective To compare the analgesic efficacy and safety of the ultrasound-guided infiltration anesthesia with the femoral sheath (IAFS) and local infiltration anesthesia (LIA) for femoral arterial access gain during endovascular aneurysm repair (EVAR) surgery. Methods A total of 256 patients who underwent EVAR via common femoral artery (CFA) under local anesthesia from January 2017 to December 2020 were retrospectively analyzed and divided into the IAFS group and the LIA group. The LIA group included 232 CFA punctures and sheath placement in 116 patients, and the IAFS group included 276 CFA punctures and sheath placement in 140 patients. The analgesic effect of IAFS and LIA in EVAR was analyzed. The technical success rate, anesthesia duration, volume of anesthetics, pain visual-analogue scale (VAS score 0-10) during operation and conversion to general anesthesia were compared between the two groups. Results There were no significant differences in technical success (100.0% vs. 99.3%) and the anesthesia time [(17.88±1.49) s vs. (18.14±1.82) s] between the LIA group and the IAFS group (P>0.05). The volume of anesthetic solution used in the IAFS group was significantly less compared to the LIA group [(17.71±1.16) mL vs. (22.72±2.38) mL, P<0.01]. The pain scores during the advancement of the delivery system or a larger profile sheath were significantly lower in the IAFS group compared to the LIA group (1.23±0.90 vs. 2.38±1.30, P<0.01). There was no significant difference in conversion to general anesthesia between the two groups (6.9% vs. 2.9%, P>0.05). Conclusion Both LIA and IAFS are safe during EVAR, but IAFS can significantly reduce patients' pain more than LIA.

Key words: anesthesia, local, femoral artery, endovascular aneurysm repair, ultrasound-guided puncture