A Case Report on Anaesthetic Management of Ruptured Abdominal Aortic Aneurysm

Abstract

Ruptured abdominal aortic aneurysm is commonly fatal with 75% mortality rate the most common cause being             atherosclerosis¹. Intraperitoneal rupture invariably leads to cardiovascular collapse and death. Emergency surgery for abdominal aortic aneurysm carries a high mortality rate of    90%.²  Even patients who survive the initial procedure are at high risk of complications like renal, cardiac, hematological, respiratory or gastrointestinal failure.

            We report a case of 59 years old male who was                   diagnosed with ruptured abdominal aortic aneurysm. Contrast CT of abdomen was suggestive of ruptured abdominal aortic aneurysm below the level of renal arteries extending up to the level of bifurcation of aorta. He underwent abdominal aortic aneurysm repair under ASA PS IV E. Patient was monitored intraoperatively with invasive blood pressure monitoring,    ETCO2, CVP, temperature, SPO2.  Hemodynamic changes during clamping and unclamping  was effectively managed using nitroglycerine and Dopamine infusion. The duration of full cross clamping was 40 minutes and partial cross clamping time was 55 minutes.Patient was maintained hemodynamically stable throughout the procedure with  intensive monitoring. In the Post operative period the patient was hemodynamically stable and urine output was within normal limits. Post operative period was uneventful and  patient was discharged after 15 days. With effective  anaesthetic management the patient survived without                     developing any complications.