Awake Aortic Surgery in a Tetraparetic Patient

A greater number of people with spinal cord injury is always submitted to surgical operations. Some pathologies associated to the medullary damage as the autonomic dysreflexia, the muscular spasm and the respiratory inadequacy can increase perioperative complications. Manifold early studies have shown that the multimodal approach in complex elective surgery can reduce perioperative morbility and mortality. We describe the case of a 77 year-old patient tetraparetic scheduled for open abdominal aortic aneurismectomy using multimodal approach that consists in minimal invasive surgery (subcostal incision), thoracic epidural anesthesia with light sedation and postoperative forced rehabilitation. This approach has allowed the decrease of perioperatorie complications and the improvement of postoperative outcome.