Epidural Anesthesia in a Patient with High Cardiac Risk

We consider that epidural anesthesia is preferable as an alternative regarding the risks of spinal anesthesia and general anesthesia for high cardiac risky patients.

📌 3 Key Takeaways

🎯

Objective & Hypothesis:Cardiac morbidity is the most common cause postoperative mortality furthermore anesthesia technics are associated with cardiac morbidity and mortality.

📊

Key Findings & Data:A 48-year-old male, 90 kg, ASA physical status IV patient underwent femoropopliteal bypass under epidural anesthesia.

💡

Conclusion & Impact:We consider that epidural anesthesia is preferable as an alternative regarding the risks of spinal anesthesia and general anesthesia for high cardiac risky patients.

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Domain Parameters

Abstract

Cardiac morbidity is the most common cause postoperative mortality furthermore anesthesia technics are associated with cardiac morbidity and mortality. A 48-year-old male, 90 kg, ASA physical status IV patient underwent femoropopliteal bypass under epidural anesthesia. Comorbidities included atrial fibrillation, dilated cardiomyopathy and 20% left ventricular ejection fraction. Epidural anesthesia was established with bupivacaine and fentanyl at L3-L4 intervertebral space. Hemodynamic stability and pain relief were established during and after the surgery. We consider that epidural anesthesia is preferable as an alternative regarding the risks of spinal anesthesia and general anesthesia for high cardiac risky patients.

🔖

Cite This Article

DOĞU, T., ŞAHİN, H., KURT, T., KİRAZ, H. A., ALTINIŞIK, U., TOMAN, H., ŞİMŞEK, T., ALTİNİSİK, H. B., YENER, A. Ü., ERBAŞ, M. (2015). Epidural Anesthesia in a Patient with High Cardiac Risk. Acta Medica Anatolia, Cilt: 3 - Sayı: 3, 102–104. https://ajindex.com/articles/143165

📄 Full Text PDF Viewer

Open in New Tab ↗

↗New Tab

📄

PDF görüntüleyici hazırlanıyor...

References (8)

Mangano DT. Perioperative cardiac morbidity. Anesthesiology 72:153-184,1990
Moraca RJ, Sheldon DG, Thirlby RC. The role of epidural anesthesia and analgesia in surgical practice. Ann Surg. 2003;238:663673
Perrino AC, Popescu WM, Skubes NJ. Echocardiography. In: Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC (Eds): Clinical Anaesthesia. Lippincolt Williams Wilkins, Philadelphia, 2009, pp 715-50
ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2007;116(17);418-99
Liu SS, Wu CL. Effect of postoperative analgesia on postoperative mortality and morbidity: an update of the evidence. Anesth Analg 2007;104:689-702
Liu S, Carpenter RL, Neal JM. Epidural anesthesia and analgesia. Anesthesiology. 1995;82:1474 1506
Miller RD. Millers Anesthesia. Seventh edition. Phladelphia: Churchill Livingstone Elsevier Inc. 2010; 2020-26
Rosenbaum GJ, Arroyo PJ., Sivina M. Retroperitoneal Approach Used Exclusively With Epidural Anesthesia for Infrarenal Aortic Disease. Am J. Surg. 1994; 168: 136-139 9. Gold MS, DeCrosta D, Rizzuto C, Ben-Harari RR, Ramanathan S. The effect of lumbar epidural and general anesthesia on plasma catecholamines and hemodynamics during abdominal aortic aneurysm repair. Anesth Analg. 1994;78:225-230. 10.Christopherson R, Beattie C, Frank SM, Norris EJ, Meinert CL, Gottlieb SO, et al. Perioperative morbidity in patients randomized to epidural or general anesthesia for lower extremity vascular surgery. Perioperative Ischemia Randomized Anesthesia Trial Study Group. Anesthesiology. 1993;79:422-434. 11.Arık H, Erhan ÖL, Beştaş A, Özer AB, Yıldızhan Ö. The effect of a single or fractional dose of local anesthetic on hemodynamics in epidural anesthesia evaluated according to ejection fraction. Turkish Journal of Geriatrics 2012; 15 (4) 439- 444.