Open Access Open Access  Restricted Access Subscription Access

Choice of Anaesthesia in Patient with Severe Pulmonary Hypertension Scheduled for Orthopaedic Surgery – A Case Report


Affiliations
1 Department of Anaesthesiology and Critical Care, Subharti Medical College, Meerut − 250005, Uttar Pradesh, India
 

Anaesthesia in surgical patient with severe pulmonary hypertension is very challenging. It needs to weigh pros and cons of choice of anaesthetic technique. A little pendulum shift on either side can prove catastrophic. A 45 years male with severe pulmonary hypertension scheduled for internal fixation of fracture of neck of femur was managed successfully under graded epidural anaesthesia. We discuss pros and cons of anaesthetic technique and importance of invasive monitoring and meticulous intraoperative fluid and paus management to achieve desirable outcome.

Keywords

Anaesthetic, Epidural Anaesthesia, Pulmonary Hypertension.
User
Notifications
Font Size

  • Gille J, Seyfarth HJ, Gerlach S, Malcharek M, Czeslick E, Sablotzki A. Perioperative Anesthesiological Management of Patients with Pulmonary Hypertension. Hindawi Publishing Corporation. Anesthesiology Research and Practice. 2012; 356982:6.
  • Curr Opin Anaesthesiol. 2010; 23:411-16. WoltersKluwer Health | Lippincott Williams & Wilkins 0952-7907
  • Ramakrishna G, Sprung J, Ravi BS, Chandrasekaran K, Mc Goon MD. Pulmonary Hypertension and Postoperative Outcomes. JACC. 2005; 45(10):1691-9.
  • Kaddoum R, Mubarak K, Chidiac EJ. Pulmonary hypertension and anesthesia. M.E.J. Anesth. 2006; 18(6):1095-112.
  • Kalarickal PL, Bent ST, Yarborough MJ, Mathew KA, Fox C. Perioperative Management of Pulmonary Hypertension, Pulmonary Hypertension - From Bench Research to Clinical Challenges, Dr. Roxana Sulica (Ed.), ISBN: 978-953-307-835-9.2011.
  • Ortega R, Connor CW. Intraoperative management of patients with pulmonary hypertension. Adv. Pulm. Hyper. 2013; 12(1).
  • Ramakrishna G, Sprung J, Ravi BS, Chandrasekaran K, McGoon MD. Pulmonary hypertension and postoperative outcomes. JACC. 2005; 45(10):1691-99.

Abstract Views: 421

PDF Views: 101




  • Choice of Anaesthesia in Patient with Severe Pulmonary Hypertension Scheduled for Orthopaedic Surgery – A Case Report

Abstract Views: 421  |  PDF Views: 101

Authors

Salony Agarwal
Department of Anaesthesiology and Critical Care, Subharti Medical College, Meerut − 250005, Uttar Pradesh, India
Vijendra Pal Singh
Department of Anaesthesiology and Critical Care, Subharti Medical College, Meerut − 250005, Uttar Pradesh, India

Abstract


Anaesthesia in surgical patient with severe pulmonary hypertension is very challenging. It needs to weigh pros and cons of choice of anaesthetic technique. A little pendulum shift on either side can prove catastrophic. A 45 years male with severe pulmonary hypertension scheduled for internal fixation of fracture of neck of femur was managed successfully under graded epidural anaesthesia. We discuss pros and cons of anaesthetic technique and importance of invasive monitoring and meticulous intraoperative fluid and paus management to achieve desirable outcome.

Keywords


Anaesthetic, Epidural Anaesthesia, Pulmonary Hypertension.

References