Is It Still Prohibited to Perform Spinal Anesthesia in Patients with Advanced Heart Disease?

Spinal anesthesia is generally prohibited in patients with severe valvular heart disease (e.g. severe aortic stenosis), cardiomyopathies and heart failure concerning the hemodynamic effects of sympathetic system blockade in patients with limited cardiac output. Intrathecal single injection of low d...

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Bibliographic Details
Main Authors: Maryam Vosoughian, Shide Dabir, Faramarz Mosaffa
Format: Article
Language:English
Published: Tehran University of Medical Sciences 2024-09-01
Series:Archives of Anesthesia and Critical Care
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Online Access:https://aacc.tums.ac.ir/index.php/aacc/article/view/1012
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Summary:Spinal anesthesia is generally prohibited in patients with severe valvular heart disease (e.g. severe aortic stenosis), cardiomyopathies and heart failure concerning the hemodynamic effects of sympathetic system blockade in patients with limited cardiac output. Intrathecal single injection of low doses of local anesthetic  in combination with low dose short acting opioids can be administered safely in lower abdominal and lower limb surgeries lasting 60 to 90 minutes . In longer surgeries, epidural catheters can be inserted through the epidural needle into the intraspinal space and intermittently administered low doses of local anesthetic plus low doses of fentanyl or sufentanil as needed.
ISSN:2423-5849