Neuraxial anesthesia for patients with severe pulmonary arterial hypertension undergoing urgent open abdominal surgeries: two case reports

Background There is no consensus regarding the choice of anesthetic method for patients with pulmonary hypertension (PH). We report two cases in which neuraxial anesthesia was safely performed without general anesthesia during open abdominal surgery in patients with severe PH. Case presentation Case...

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Bibliographic Details
Published in:JA clinical reports 2024-09, Vol.10 (1), p.52-6, Article 52
Main Authors: Yamada, Shuhei, Takise, Yoshiaki, Sekiya, Yuri, Masuda, Yuya, Misonoo, Yoshi, Wakaizumi, Kenta, Suhara, Tomohiro, Morisaki, Hiroshi, Kato, Jungo, Yamada, Takashige
Format: Article
Language:English
Subjects:
Abdomen
Abdominal surgery
Adult congenital heart disease
Anesthesiology
Blood pressure
Case Report
Case reports
Catheters
Critical Care Medicine
Dyspnea
Emergency Medicine
Epidural
General anesthesia
Heart failure
Hemodynamics
Intensive
Local anesthesia
Medicine
Medicine & Public Health
Neuraxial anesthesia
Noncardiac surgery
Ovaries
Pain Medicine
Patients
Pulmonary arteries
Pulmonary hypertension
Veins & arteries
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Summary:Background There is no consensus regarding the choice of anesthetic method for patients with pulmonary hypertension (PH). We report two cases in which neuraxial anesthesia was safely performed without general anesthesia during open abdominal surgery in patients with severe PH. Case presentation Case 1: A 59-year-old woman had an atrial septal defect and a huge abdominal tumor with a mean pulmonary arterial pressure (PAP) of 39 mmHg and pulmonary vascular resistance (PVR) of 3.5 Wood units. Case 2: A 23-year-old woman who had hereditary pulmonary artery hypertension (mean PAP, 65 mmHg; PVR, 16.45 Wood units). Both patients underwent open abdominal surgery under neuraxial anesthesia without circulatory collapse with intraoperative administration of vasoconstrictors. Conclusion Although anesthetic care must be personalized depending on the pathology and severity of PH, neuraxial anesthesia may be an option for patients with severe PH undergoing abdominal surgery.
ISSN:2363-9024
2363-9024
DOI:10.1186/s40981-024-00737-w