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Combined spinal-epidural anesthesia for lumbar discectomy in a patient with asymptomatic severe aortic stenosis -a case report-

Authors
Kim Y.S.Park J.H.Lee S.Y.Lim B.G.Kim H.Lee I.-O.Kong M.-H.
Issue Date
1-Aug-2014
Publisher
Korean Society of Anesthesiologists
Keywords
Aortic stenosis; Combined spinal epidural anesthesia; Dexmedetomidine; Regional anesthesia
Citation
Korean Journal of Anesthesiology, v.67, no.2, pp 129 - 132
Pages
4
Indexed
SCOPUS
KCI
Journal Title
Korean Journal of Anesthesiology
Volume
67
Number
2
Start Page
129
End Page
132
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/9890
DOI
10.4097/kjae.2014.67.2.129
ISSN
2005-6419
2005-7563
Abstract
The use of neuraxial anesthesia has traditionally been contraindicated in patients with severe aortic stenosis. However, general anesthesia can be riskier than neuraxial anesthesia for severe aortic stenosis patients undergoing spinal surgeries in the prone position as this can cause a major reduction in cardiac output secondary to diminished preload. In addition, general anesthesia, muscle relaxation, and positive-pressure ventilation can decrease venous return and reduce vascular tone, further compromising cardiac output. Combined spinal-epidural anesthesia with closely monitored, careful titration of the local anesthetic dose can be an efficient and safe anesthetic method for managing such patients. We describe the successful management of combined spinal-epidural anesthesia in an asymptomatic severe aortic stenosis patient scheduled for lumbar discectomy. © the Korean Society of Anesthesiologists, 2014.
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Lim, Byung Gun
Guro Hospital (Department of Anesthesiology and Pain Medicine, Guro Hospital)
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