2016
DOI: 10.1016/j.bjane.2013.03.010
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Continuous spinal anaesthesia with minimally invasive haemodynamic monitoring for surgical hip repair in two patients with severe aortic stenosis

Abstract: Our report illustrates the use of continuous spinal anaesthesia with minimally invasive haemodynamic monitoring as a valid alternative to general or epidural anaesthesia in two patients with severe aortic stenosis who are undergoing lower limb surgery. However, controlled clinical trials would be required to establish that this technique is safe and effective in these type or patients.

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Cited by 11 publications
(10 citation statements)
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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%
“…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%
“…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%
“…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%