Anaesthetic management of an elderly patient with ischaemic heart disease and previous MI undergoing elective inguinal hernia repair: Case report
Published on: 25th May, 2020
OCLC Number/Unique Identifier: 8615126196
Ischemic heart disease may occur in isolation, or in combination with the pathological process of vascular ageing, arteriosclerosis. These two conditions have differing impacts on the haemodynamic changes in response to anaesthesia and surgery. Hypertension is not a feature of ischemic heart disease, and vice versa, but where the two conditions co-exist, hypertension aggravates and accelerates the pathological processes of ischemic heart disease. Patients older than 40 yrs. presenting for anaesthesia and surgery must therefore be considered at risk of any combination of these three conditions. Anaesthetic techniques must also be chosen to minimize haemodynamic changes which in the normal healthy patient cause no serious morbidity, but which, in the patient with ischemic heart disease, can lead to serious morbidity or death. Here we report a 70 years old (BMI of 23.3) elderly, hypertensive Male patient with ischemic heart disease with previous MI (EF of 40% - 5%) undergoing elective Inguinal hernia repair. We Opted Spinal anesthesia over General anaesthesia as it should be an asset in cardiac patients undergoing non-cardiac lower abdominal surgeries to reduce preload and after load, stress response, coagulation responses, improves coronary perfusion, provides better postoperative analgesia, reduces incidence of perioperative MI, maintains myocardial oxygen supply demand ratio and avoids harmful effects of GA such as hypotention due to intravenous induction drugs, tachycardia and hypertension due to pressor response during direct laryngoscopy and tracheal intubation.
Acute abdomen as complication of a knee arthroscopy: A case report
Published on: 22nd December, 2020
OCLC Number/Unique Identifier: 8872656452
A knee arthroscopy in spinal anaesthesia was performed on a 67 years old male patient. During the procedure the patient was hemodynamically stable, until he suddenly turned pale and started complaining of severe pain in lower abdomen with signs of guarding. The procedure was finished as urgently as possible and after releasing the tourniquet we noticed significant difference in volume of the leg, with redness distal to tourniquet. Urgent lab results were essentially unremarkable and the patient was sent for the urgent radiological diagnostics.
CD of the left leg described fluid in the soft tissues of the thigh, scrotum, and abdomen; and the unenhanced CT of the abdomen showed free fluid along the entire femoral shaft of the left thigh, extending towards pelvis and abdomen to perihepatic and perisplenic space, and retroperitoneum, with gas bubbles tracking along anterior aspect of the left thigh into the left retroperitoneum.
He was admitted to the ICU, and within few hours all symptoms have resolved and his further recovery was without complications.
Comparison of Effect of Intrathecal Fentanyl 25µg with 0.5% Hyperbaric Bupivacaine and Only 0.5% Hyperbaric Bupivacaine
Published on: 12th April, 2025
Background: To enhance the duration of sensory anaesthesia and to prolong the duration of post-operative pain relief during spinal anaesthesia, various adjuvants have been tried along with local anaesthetic agent. The present study was undertaken to evaluate and compare the onset and duration of sensory block, motor block and duration of post-operative pain relief by using intrathecal 0.5% Hyperbaric bupivacaine with fentanyl 25µg versus only 0.5% Hyperbaric bupivacaine selected groups.Methods: We enrolled 70 ASA Ι & ΙΙ patients undergoing surgeries below umbilicus level for our Prospective Randomized trial. Those who met our inclusion criteria were randomized using simple random sampling technique, after obtaining informed consent. Patients in Group A received fentanyl 25µg with 0.5% Hyperbaric Bupivacaine and patients in Group B received only 0.5% Hyperbaric Bupivacaine intrathecally. Parameters like onset and duration of sensory and motor block and postoperative pain relief were observed. In postoperative period, VAS score was monitored & time for rescue analgesia was noted, when VAS exceeded 5 or above.Results: It was found that Patients in Group A had significantly prolonged duration of postoperative analgesia as compared to Group B (Z value 17.35). Results of Onset & Duration of sensory and motor block were suggesting insignificant result. Post-operative complication was insignificant in our study.Conclusion: Addition of Fentanyl 25µg with 0.5% Hyperbaric Bupivacaine in Spinal anaesthesia have insignificant effect on duration of sensory and motor blockade and prolongs postoperative pain relief.
Search by University/Institution
Enter your University/Institution to find colleagues at HSPI.
Ensuring author's satisfaction with
- Friendly and hassle-free publication process
- Less production time of articles
- Constructive peer-review
- Enhancing journal reputation
- Regular feedback system
- Quick response to authors' queries
Most Viewed Keywords
- Estimation
- Cancer
- Temporomandibular joint
- Gender change surgery
- Microbiological air contamination
- COVID-19
- Hypertrophy of the endocrine system
- Donor
- Cast glass-coated amorphous magnetic microwire
- Laparoscopic Cholecystectomy
- Hypovolemic shock
- External otitis
- Macitentan
- COVID-19
- L-asparaginase
- Airway hyperresponsiveness
- Iodine
- Sars-COV-2
- Sleep quality
- Nursing shortage
Search Articles by Country
Get all latest articles in all Heighten Science Publications Inc journals by country.
Testmonials
To the editorial team at HSPI and the Journal of Clinical Nephrology: Thank you so much for your hard work and collaboration in bringing our article to life. Your staff was responsive, flexible, and communicative and made the process smooth and easy. Thank you!
Alejandro Munoz
Thanks you and your colleague for the great help for our publication. You always provide prompt responses and high quality of service. I am so happy to have you working with me. Thanks again!
Diana (Ding) Dai
It was a real pleasure working with your team. The review was done fast, and it was very clear, the editing was flawless, the article was published quickly compared to other journals, and everyone was understanding and helpful. I will gladly recommend this journal to my acquaintances in academia.
Alexandra Cozma
“It was a delightful experience publishing my manuscript with the Clinical Journal of Obstetrics and Gynecology. They offered me lots of opportunities I never had from most publishing houses and their prompt services are greatly appreciated.”
Department of Agricultural Economics, Agribusiness and Extension, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Akowuah Jones Asafo
We really appreciate and thanks the full waiver you provide for our article. We happy to publish our paper in your journal. Thank you very much for your good support and services.
Ali Abusafia
I want to thank you for our collaboration. You were fast and effective with a positive spirit of teamwork. I am truly excited from our collaboration. You were like always fast, efficient and accurate. I hope that in the near future we will collaborate again.
Aikaterini Solomou
Thank you very much for accepting our manuscript in your journal “International Journal of Clinical Virology”. We are very thankful to the esteemed team for timely response and quick review process. The editorial team of International Journal of Clinical Virology is too cooperative and well-mannered during the publication process. We are hopeful to publish many quality papers in your journal and I suggest the International Journal of Clinical Virology to all of my colleagues, researchers and friends to publish their research here.
Abdul Baset
Archives of Vascular Medicine is one of the top class journal for vascular medicine with highly interesting topics. You did a professional and great Job!
Elias Noory
Submission of paper was smooth, the review process was fast. I had excellent communication and on time response from the editor.
Ayokunle Dada
In 2017, I submitted a manuscript to the journal Archives of Biotechnology and Biomedicine belonging to Heighten Science Publications Corporation. Within one week I already received the response from the editor. All processing steps were really fast so in terms of a speedy publication I can particularly recommend the journal Archives of Biotechnology and Biomedicine. The responsible contact person of the journal was always available, which gives a trustworthy impression to the author. Also the peer review process was clear and constructive. So from my experience with Heighten Science Publications Corporation I can recommend publishing there.
University of Tubingen, Germany
Yvonne Mast
