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.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368881 | PMC |
| http://dx.doi.org/10.1186/s40981-024-00737-w | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Effect of Anesthetic Modality on Decision-to-Delivery Interval and Maternal-Neonatal Outcomes in Category 2 and 3 Cesarean Deliveries.
J Clin Med
December 2024
Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.
The optimal anesthetic technique for category 2 and 3 cesarean deliveries remains debated, with concerns about impacts on decision-to-delivery interval (DDI) and perinatal outcomes. This study examined the influence of epidural, spinal, and general anesthesia on DDI, surgical and postoperative complications, and neonatal outcomes. : This prospective cohort study at a tertiary perinatology center enrolled parturient women undergoing category 2 and 3 cesarean deliveries.
View Article and Find Full Text PDFSpinal anesthesia for cesarean delivery in a laboring patient with known cranial arachnoid cyst: a case report.
Int J Obstet Anesth
December 2024
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham & Women's Hospital, Harvard Medical School, United States.
Arachnoid cysts are fluid-filled cavities that are usually asymptomatic and do not require surgical intervention. However, there are concerns and limited literature on the safety of neuraxial procedure in obstetric patients with cranial arachnoid cysts. We describe the anesthetic management of a pregnant patient with a large arachnoid cyst with mass effect on the cerebellum who presented in labor.
View Article and Find Full Text PDFMorbid obesity: Optimizing neuraxial analgesia and cesarean delivery outcomes.
Best Pract Res Clin Anaesthesiol
September 2024
Department of Anesthesiology, University Hospital Basel, Basel, Switzerland.
The issue of obesity continues to reach new levels globally, affecting individuals across the age continuum. Obesity in pregnancy is associated with myriad comorbidities which may negatively impact the fetus, particularly dysfunctional labor and failure to progress ending in unplanned cesarean delivery. Neuraxial anesthesia represents the gold standard for cesarean delivery anesthesia and is increasingly beneficial for obese patients due to the risk of difficult airway.
View Article and Find Full Text PDFPreeclampsia and eclampsia: Enhanced detection and treatment for morbidity reduction.
Best Pract Res Clin Anaesthesiol
September 2024
Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, L1, Boston, MA, 02115, USA. Electronic address:
Preeclampsia is a life-threatening complication that develops in 2-8% of pregnancies. It is characterized by elevated blood pressure after 20 weeks of gestation and may progress to multiorgan dysfunction, leading to severe maternal and fetal morbidity and mortality. The only definitive treatment is delivery, and efforts are focused on early risk prediction, surveillance, and severity mitigation.
View Article and Find Full Text PDFCesarean delivery: Clinical updates.
Best Pract Res Clin Anaesthesiol
September 2024
K. Bicetre School of Medicine, Paris-Saclay University, Département d'Anesthésie, Hôpital Antoine Béclère - APHP.Université Paris-Saclay, 157 rue de la porte de Trivaux, 92140, CLAMART, France. Electronic address:
This article offers a comprehensive clinical update on best practices for neuraxial and general anesthesia in cesarean delivery, the most frequently performed major surgical procedure globally. Current evidence-based strategies to address common anesthetic challenges, such as maternal hypotension and intraoperative breakthrough pain, are discussed in detail. Practical approaches for optimizing maternal hemodynamic stability, including the use of vasopressors, fluid management and maternal positioning, are reviewed.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!