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- Title
Combined spinal-epidural anesthesia for lumbar discectomy in a patient with asymptomatic severe aortic stenosis.
- Authors
Young Sung Kim; Ji Hye Park; Shin Young Lee; Byung Gun Lim; Heezoo Kim; Il-ok Lee; Myoung-Hoon Kong
- 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 titra-tion 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.
- Subjects
SPINAL anesthesia; DISCECTOMY; AORTIC stenosis; GENERAL anesthesia; CARDIAC output; MUSCLE contraction; PATIENTS
- Publication
Korean Journal of Anesthesiology, 2014, Vol 67, Issue 2, p129
- ISSN
2005-6419
- Publication type
Case Study
- DOI
10.4097/kjae.2014.67.2.129