Anesthetic management of nephrectomy in a chronic obstructive pulmonary disease patient with recurrent spontaneous pneumothorax

Santhosh, M.C.B.; Pai, Rohini Bhat; Rao, Raghavendra Pralhada

doi:10.1016/j.bjane.2014.02.002

Cited by 3 publications

(3 citation statements)

References 3 publications

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“…While low anterior rectal resection is commonly performed under GA with the potential role of epidural analgesia intra- and postoperatively, we achieved positive results by employing CSE as an alternative technique in a very sick patient. Epidural analgesia is associated with improved health outcomes for surgical patients with COPD to reduce post-operative complications [ 5 ] and CSE anesthesia has been successfully implemented as the sole anesthetic technique in major abdominal surgeries in patients with COPD [ 6 ]. In patients with interstitial lung disease, a regional technique or NA may be considered a choice for the avoidance of GA and its complications [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Neuraxial Anesthesia for an Open Low Anterior Rectal Resection: Tip the Scales in Patient’s Favor

Marrone,

Fusco,

Lepre

et al. 2024

Cureus

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We present the case of a successful application of combined spinal-epidural anesthesia for a geriatric patient undergoing open cancer surgery. The patient, affected by multiple comorbidities, was proposed for an open anterior rectal resection. The implementation of a tailored protocol, incorporating neuraxial techniques such as epidural and spinal anesthesia, facilitated optimal pain management and expedited postoperative recovery improving perioperative outcomes, and highlighting the potential benefits of such strategies in selected cases.

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Section: Discussionmentioning

confidence: 99%

Neuraxial Anesthesia for an Open Low Anterior Rectal Resection: Tip the Scales in Patient’s Favor

Marrone,

Fusco,

Lepre

et al. 2024

Cureus

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“…Combined spinal epidural anaesthesia has been successfully used as a sole anaesthetic technique in major abdominal surgeries in patients with COPD. [ 46 ] In spite of conflicts in opinion with regards to benefits of epidural analgesia in COPD patients,[ 28 ] recent evidence favours use thoracic epidural anaesthesia and analgesia in these patients to reduce post-operative complications. [ 45 47 ] Use of interscalene block in patients with COPD remains a concern due to ipsilateral phrenic nerve paralysis and loss of sympathetic tone due to stellate ganglion block resulting in bronchospasm.…”

Section: Intraoperative Managementmentioning

confidence: 99%

Anaesthesia for patient with chronic obstructive pulmonary disease

2015

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The chronic obstructive pulmonary disease has become a disease of public health importance. Among the various risk factors, smoking remains the main culprit. In addition to airway obstruction, the presence of intrinsic positive end expiratory pressure, respiratory muscle dysfunction contributes to the symptoms of the patient. Perioperative management of these patients includes identification of modifiable risk factors and their optimisation. Use of regional anaesthesia alone or in combination with general anaesthesia improves pulmonary functions and reduces the incidence of post-operative pulmonary complications.

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“…PEC blocks associated with risk of intra vascular injection, pleural injury and risk of brachial plexus block. However, regional anaesthesia including central neuraxial block proved that it eliminate the need for airway manipulation and was associated with 50% Reduction in PPC (post-operative pulmonary complications) 7,8,9 .…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Segmental Thoracic Spinal Anaesthesia in Breast Surgery: An Observational Study

Ullah,

Kamal,

Begum

et al. 2024

J Shaheed Suhrawardy Med Coll

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Background: General anaesthesia is usually performed for breast surgery but the risks and complications of general anaesthesia outweigh its benefits. For this, segmental thoracic spinal anesthesia might be an alternative to general anesthesia. Objectives: The objective of this study was to evaluate the effectiveness segmental thoracic spinal anaesthesia in breast surgery. Methods: This prospective observational study was conducted at surgery operation theatre in the Shaheed Suhrawardy Medical College and Hospital, Dhaka, Bangladesh from January 2023 to December 2023. Patients of ASA (American Society of Anesthesiologist) class I and II, ageing above 18 years, and BMI < 35 kg/m2 scheduled for breast surgery (modified radical mastectomy for carcinoma breast, lumpectomy for breast lump/gynaecomastia, and wide local excision for phylloids tumor) were included in this study. Segmental thoracic spinal anaesthesia was performed at T5-T6 space with injection 0.5% hyperbaric bupivacaine 1 ml (5mg) and fentanyl 0.5 ml (25 microgram). Perioperative hemodynamic changes, unwanted effects, time of first rescue analgesic, total opioid consumption in first 24 h, patient and surgeon satisfaction score were recorded in a data sheet. Results: Sixty patients were eligible for the study but 55 patients completed the study successfully. Modified radical mastectomy, Lumpectomy and Wide local excision were done in 42 (76%), 8 (15%) and 5 (9%) patients, respectively. The mean age of the patients was 50.78±8.98 years. There were no significant changes in haemodynamic parameters during the intraoperative period. The frequency of adverse effects were minimal. Mean time for 1st dose of analgesic was 5.8±1.8 hours and total opioid consumption was 76.77±15.7 mg in first 24 hours. Both patient (91%) and surgeon (95%) were highly satisfied with this technique. Conclusions: Segmental thoracic spinal anaesthesia provides better satisfaction and fewer complications in patients undergoing breast surgery. This regional anaesthesia technique can be used effectively for breast surgeries. J Shaheed Suhrawardy Med Coll 2022; 14(2): 47-52

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Anesthetic management of nephrectomy in a chronic obstructive pulmonary disease patient with recurrent spontaneous pneumothorax

Cited by 3 publications

References 3 publications

Neuraxial Anesthesia for an Open Low Anterior Rectal Resection: Tip the Scales in Patient’s Favor

Neuraxial Anesthesia for an Open Low Anterior Rectal Resection: Tip the Scales in Patient’s Favor

Anaesthesia for patient with chronic obstructive pulmonary disease

Effectiveness of Segmental Thoracic Spinal Anaesthesia in Breast Surgery: An Observational Study

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