Graded Epidural Anaesthesia as the Sole Anaesthetic Technique for Bilateral Total Knee Replacement in a Patient with Low Ejection Fraction: A Case Report
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Abstract
In patients with cardiac disease, it’s always a challenge for the anaesthetist to administer general anaesthesia as well as central neuraxial blockade. The major perioperative task in these patients with low cardiac output is maintaining hemodynamic stability. Here, we are discussing a case of successful management of a geriatric patient having ischemic heart disease with ejection fraction of 25% posted for bilateral total knee replacement under graded epidural anaesthesia.
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[2]Kristensen SD, Knuuti J, Saraste A, Anker S, Bøtker HE, De Hert S, et al. 2014 ESC/ESA guidelines on non-cardiac surgery: cardiovascular assessment and management: the joint task force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaest. Eur J Anaesthesiol. 2014; 31(10):517–73.
[3]Chen C-Q, Wang X, Zhang J, Zhu S-M. Anesthetic management of patients with dilated cardiomyopathy for noncardiac surgery. Eur Rev Med Pharmacol Sci. 2017; 21(3):627–634.
[4]Deshpande C, Fernandes S, Dhakne G. “Dialated cardiomyopathy and end stage renal disease with renal osteodystrophy for bilateral transcervical fracture femur fixation,” Internet Journal of Anesthesiology. 2009; 20:1-3.
[5]Forster JG, Rosenberg PH. Small dose of clonidine mixed with low-dose ropivacaine and fentanyl for epidural analgesia after total knee arthroplasty. Br J Anaesth. 2004; 93:670–7
[6]Thobhani S, Scalercio L, Elliott CE, Nossaman BD, Thomas LC, Yuratich D, et al. Novel Regional Techniques for Total Knee Arthroplasty Promote Reduced Hospital Length of Stay: An Analysis of 106 Patients. Ochsner J. 2017;17(3):233-238
[7]Bourne E, Wright C, Royse C. A review of local anesthetic cardiotoxicity and treatment with lipid emulsion. Local and regional anesthesia. 2010; 3:11-19.
| Files | ||
| Issue | Vol 8 No Supp. 1 (2022): Supplement 1 |
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| Section | Case Report(s) | |
| Keywords | ||
| Graded epidural anaesthesia low ejection fraction ischemic heart disease total knee replacement | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Chandran P, Perween R, John B, Shajahan MS, Ramesh R. Graded Epidural Anaesthesia as the Sole Anaesthetic Technique for Bilateral Total Knee Replacement in a Patient with Low Ejection Fraction: A Case Report. Arch Anesth & Crit Care. 2022;8(Supp. 1):420-422.
