Is It Still Prohibited to Perform Spinal Anesthesia in Patients with Advanced Heart Disease?
Spinal anesthesia in advanced cardiac disease
Abstract
Spinal anesthesia is generally prohibited in patients with severe valvular heart disease (e.g. severe aortic stenosis), cardiomyopathies and heart failure concerning the hemodynamic effects of sympathetic system blockade in patients with limited cardiac output. Intrathecal single injection of low doses of local anesthetic in combination with low dose short acting opioids can be administered safely in lower abdominal and lower limb surgeries lasting 60 to 90 minutes . In longer surgeries, epidural catheters can be inserted through the epidural needle into the intraspinal space and intermittently administered low doses of local anesthetic plus low doses of fentanyl or sufentanil as needed.
[1] Li M, Huang H. Anesthetic Management of Patients with Dilated Cardiomyopathy Undergoing Noncardiac Surgery. Medicina. 2023; 59(9):1567.
[2] Lopes L, Marialva J, Cardoso H. Spinal Anesthesia in Hemodynamic Instability: A Case Report. Cureus. 2023; 15(1):e33821.
[3] Vosoughian M, Azimaraghi O, Moshari MR, Dahi M, Ghasemi M, Khazaei N. The Effect of Different Combination Doses of Intrathecal Hyperbaric Bupivacaine 0.5% and Sufentanil on the Hemodynamic Profile of Geriatric Patients Undergoing Hip Surgery under Spinal Anesthesia. Acad J Surg, 2016; 3(3-4): 42-5.
[4] Almeida CR, Vieira LS, Cunha P, Gomes A. Low-dose spinal block combined with epidural volume extension in a high-risk cardiac patient: A case-based systematic literature review. Saudi J Anaesth. 2022; 16(4):383-389.
[2] Lopes L, Marialva J, Cardoso H. Spinal Anesthesia in Hemodynamic Instability: A Case Report. Cureus. 2023; 15(1):e33821.
[3] Vosoughian M, Azimaraghi O, Moshari MR, Dahi M, Ghasemi M, Khazaei N. The Effect of Different Combination Doses of Intrathecal Hyperbaric Bupivacaine 0.5% and Sufentanil on the Hemodynamic Profile of Geriatric Patients Undergoing Hip Surgery under Spinal Anesthesia. Acad J Surg, 2016; 3(3-4): 42-5.
[4] Almeida CR, Vieira LS, Cunha P, Gomes A. Low-dose spinal block combined with epidural volume extension in a high-risk cardiac patient: A case-based systematic literature review. Saudi J Anaesth. 2022; 16(4):383-389.
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| Issue | Article in Press |
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| Section | Letter to Editor | |
| Keywords | ||
| Heart disease local anestetic opioid opioid spinal anesthesia | ||
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How to Cite
1.
Vosoughian M, Dabir S, Mosaffa F. Is It Still Prohibited to Perform Spinal Anesthesia in Patients with Advanced Heart Disease?. Arch Anesth & Crit Care. 2024;.
