Neuraxial anesthesia for patients with severe pulmonary arterial hypertension undergoing urgent open abdominal surgeries: two case reports

Autor: Shuhei Yamada, Yoshiaki Takise, Yuri Sekiya, Yuya Masuda, Yoshi Misonoo, Kenta Wakaizumi, Tomohiro Suhara, Hiroshi Morisaki, Jungo Kato, Takashige Yamada
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: JA Clinical Reports, Vol 10, Iss 1, Pp 1-6 (2024)
Druh dokumentu: article
ISSN: 2363-9024
DOI: 10.1186/s40981-024-00737-w
Popis: Abstract Background There is no consensus regarding the choice of anesthetic method for patients with pulmonary hypertension (PH). We report two cases in which neuraxial anesthesia was safely performed without general anesthesia during open abdominal surgery in patients with severe PH. Case presentation Case 1: A 59-year-old woman had an atrial septal defect and a huge abdominal tumor with a mean pulmonary arterial pressure (PAP) of 39 mmHg and pulmonary vascular resistance (PVR) of 3.5 Wood units. Case 2: A 23-year-old woman who had hereditary pulmonary artery hypertension (mean PAP, 65 mmHg; PVR, 16.45 Wood units). Both patients underwent open abdominal surgery under neuraxial anesthesia without circulatory collapse with intraoperative administration of vasoconstrictors. Conclusion Although anesthetic care must be personalized depending on the pathology and severity of PH, neuraxial anesthesia may be an option for patients with severe PH undergoing abdominal surgery.
Databáze: Directory of Open Access Journals