Continuous spinal anaesthesia with minimally invasive haemodynamic monitoring for surgical hip repair in two patients with severe aortic stenosis

López, María Mercedes; Guasch, E.; Schiraldi, R.; Maggi, G.; Alonso, Eduardo Torres; Gilsanz, F.

doi:10.1016/j.bjane.2013.03.010

Cited by 11 publications

(11 citation statements)

References 8 publications

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“…Because of this, neuraxial anesthetics have generally been avoided in AS patients to prevent the hypotension associated with these techniques [5]. However, though counterintuitive, a few reports suggest a carefully titrated neuraxial anesthetic may be a viable and safe alternative to general anesthesia in patients with AS undergoing noncardiac surgery [6,7]. We present our experience managing a patient with severe AS undergoing a total knee arthroplasty (TKA) using a continuous spinal anesthetic and intraoperative sedation.…”

Section: Introductionmentioning

confidence: 99%

Continuous Spinal Anesthetic in a Patient with Severe Aortic Stenosis for Total Knee Arthroplasty

Jensen¹,

Ac²

2019

J Clin Anesth Pain Manag

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Section: Introductionmentioning

confidence: 99%

Continuous Spinal Anesthetic in a Patient with Severe Aortic Stenosis for Total Knee Arthroplasty

Jensen¹,

Ac²

2019

J Clin Anesth Pain Manag

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“…The use of different types and sizes of needles may explain this difference. Some studies used the CSA for post-operative analgesia for abdominal, vascular, hip surgery [14] and severe aortic stenosis with hip fracture [15]. Because we used lumbar plexus block (anterior and posterior) with neurostimulator, the use of CSA for postoperative analgesia was not practiced in our routine and all catheters were removed at the end of surgery.…”

Section: Resultsmentioning

confidence: 99%

Continuous Spinal Anesthesia with Spinocath® Catheter. A Retrospective Analysis of 455 Orthopedic Elderly Patients in the past 17 years

Imbelloni

2020

OSMOAJ

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Background and Objectives: Database analysis in general cost less and require less time as compared to large randomized controlled trials. This retrospective study with a catheter outside the cutting-tip needle for continuous spinal anesthesia for femur and hip surgery in elderly patients from 1998 to 2015, with the aim of determine possible advantages and disadvantages of this technique.Methods: Anesthetic records of 455 patients receiving continuous spinal anesthesia over a 17-year period were analyzed retrospectively. All blockades were performed with patients in the left lateral position and by the two authors. Doses of 0.5% isobaric bupivacaine were administered according to the patient's height. Evaluated parameters were: puncture success, highest level of anesthesia, lower limb motor block, quality of anesthesia, need for additional doses, failures incidence, paresthesia, postdural puncture headache, cardiovascular changes, mental confusion and delirium, blood transfusion and mortality.Results: Seven patients were excluded for failure to puncture and accidental perforation of the duramater. The mean time for puncture and placement of the catheter was 2.66±1.03 min. The kit was easy to use in 376 patients and difficult in 42 patients. In all patients the catheter was inserted from 1 to 2 cm in the subarachnoid space. The mode of dispersion cephalad analgesia was T12. In 360 patients, the initial dose was sufficient to reach T12 and 88 patients required to supplement the dose. Mean isobaric bupivacaine initial dose was 7.74±1.78 mg and total dose was 8.58±2.60 mg. Hypotension occurred in 32 patients and bradycardia in 21 patients. Low intensity headache lasting for 3 days has been observed in seven patients. There has been no cauda equina syndrome or transient radicular irritation. Mental confusion occurred in 29 patients. Conclusions:Our results with 455 patients over 17 years suggest that continuous spinal anesthesia with the catheter outside the needle for elderly orthopedic patient's shows minor insertion problem, a low incidence of hypotension, paresthesia and headache. No neurological complications were observed, such as cauda equina syndrome or transient neurological symptoms.

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“…However, few studies address the efficacy of non-invasive hemodynamic monitors in patients with significant valvulopathies. Case reports describe using the MICM for management of severe aortic stenosis during hip surgery and severe MR during cerebral aneurysm surgery [11,12]. However, recent randomized trials using these devices on patients undergoing large abdominal surgeries specifically excluded patients with moderate to severe valve disease [13].…”

Section: Discussionmentioning

confidence: 99%

Utility of Minimally Invasive Cardiovascular Monitoring in the High-Risk Patient Undergoing Radical Cystoprostatectomy: A Case Report

Aldawoodi

Hoffman

Escher

2020

Cureus

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Non-cardiac surgery in a high-risk patient with severe mitral stenosis (MS) and severe pulmonary hypertension (PH) presents a significant anesthetic challenge. Guidelines recommend using advanced hemodynamic monitors for specific cardiovascular goals. The gold standard for intraoperative monitoring in these cases is the pulmonary artery catheter (PAC) and transesophageal echocardiography (TEE). This case discusses the successful management of a severe MS patient undergoing cystoprostatectomy using a minimally invasive cardiovascular monitor (MICM) incorporating several hemodynamic parameters.

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Continuous spinal anaesthesia with minimally invasive haemodynamic monitoring for surgical hip repair in two patients with severe aortic stenosis

Cited by 11 publications

References 8 publications

Continuous Spinal Anesthetic in a Patient with Severe Aortic Stenosis for Total Knee Arthroplasty

Continuous Spinal Anesthetic in a Patient with Severe Aortic Stenosis for Total Knee Arthroplasty

Continuous Spinal Anesthesia with Spinocath® Catheter. A Retrospective Analysis of 455 Orthopedic Elderly Patients in the past 17 years

Utility of Minimally Invasive Cardiovascular Monitoring in the High-Risk Patient Undergoing Radical Cystoprostatectomy: A Case Report

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