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Choice Of Anesthetic Technique And Agent
➤ The SVS recommends general endotracheal anesthesia for patients
undergoing open aneurysm repair. (1-A)
Antibiotic Prophylaxis
➤ The SVS recommends intravenous administration of a first-generation
cephalosporin or, in the event of penicillin allergy, vancomycin within
30 minutes before OSR or EVAR. Prophylactic antibiotics should be
continued for ≤24 hours. (1-A)
➤ The SVS recommends that any potential sources of dental sepsis be
eliminated ≥2 weeks before implantation of an aortic prosthesis.
(G-U)
Intraoperative Fluid Resuscitation And Blood Conservation
➤ The SVS recommends using cell salvage or an ultrafiltration device if
large blood loss is anticipated. (1-B)
➤ If the intraoperative hemoglobin level is <10 g/dL and blood loss is
ongoing, the SVS recommends transfusion of packed blood cells along
with fresh frozen plasma and platelets in a ratio of 1:1:1. (1-B)
Cardiovascular Monitoring
➤ The SVS suggests using pulmonary artery catheters only if the
likelihood of a major hemodynamic disturbance is high. (1-B)
➤ The SVS recommends central venous access and arterial line
monitoring in all patients undergoing open aneurysm repair. (1-B)
➤ The SVS recommends postoperative ST-segment monitoring for all
patients undergoing open aneurysm repair and for those patients
undergoing EVAR who are at high cardiac risk. (1-B)
➤ The SVS recommends postoperative troponin measurement for
all patients with electrocardiographic changes or chest pain after
aneurysm repair. (1-A)
Maintenance of Body Temperature
➤ The SVS recommends maintaining core body temperature ≥36ºC
during aneurysm repair. (1-A)
