Perioperative management of an elderly patient of hypertrophic obstructive cardiomyopathy for knee arthroplasty and the role of peripheral nerve blocks
| Autor: | Sneh Lata, Swati Jindal, Sunny Rupal, Adarsh C Swami |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
femoral nerve block business.industry medicine.medical_treatment Ventricular outflow tract obstruction Case Report Perioperative knee arthroplasty Obstructive cardiomyopathy Arthroplasty Surgery lcsh:RD78.3-87.3 Anesthesiology and Pain Medicine Femoral nerve lcsh:Anesthesiology Anesthesia Medicine General anaesthesia medicine.symptom business Elderly patient Complication Elderly hypertrophic obstructive cardiomyopathy |
| Zdroj: | Indian Journal of Anaesthesia, Vol 57, Iss 4, Pp 394-396 (2013) Indian Journal of Anaesthesia |
| ISSN: | 0019-5049 |
| Popis: | This case report exemplifies how the anaesthetic technique of general anesthesia with continuous bilateral femoral nerve block for bilateral knee arthroplasty was well chosen for the management of perioperative complications in an elderly patient with hypertrophic obstructive cardiomyopathy (HOCM). A 69-year-old female patient of HOCM was scheduled for bilateral total knee replacement. Echocardiography revealed severe left ventricular outflow tract obstruction with peak systolic gradient of 56 mmHg. The surgery was conducted under general anaesthesia with invasive monitoring and bilateral continuous femoral nerve blocks for postoperative analgesia. Postoperatively, she developed pulmonary oedema due to the liberal administration of fluids. This complication was successfully managed without interrupting the management of pain. Management of patients with HOCM for noncardiac surgery requires knowledge of variable presentation of two forms of disease. Also, this case report highlights the practical advantage of continuous femoral nerve block (CFNB)s over epidural anaesthesia. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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