Perioperative management of an elderly patient of hypertrophic obstructive cardiomyopathy for knee arthroplasty and the role of peripheral nerve blocks

This case report exemplifies how the anaesthetic technique of general anesthesia with continuous bilateral femoral nerve block for bilateral knee arthroplasty was well chosen for the management of perioperative complications in an elderly patient with hypertrophic obstructive cardiomyopathy (HOCM)....

Full description

Saved in:
Bibliographic Details
Published inIndian journal of anaesthesia Vol. 57; no. 4; pp. 394 - 396
Main Authors Rupal, Sunny, Swami, Adarsh, Jindal, Swati, Lata, Sneh
Format Journal Article
LanguageEnglish
Published India Medknow Publications 01.07.2013
Medknow Publications and Media Pvt. Ltd
Medknow Publications & Media Pvt. Ltd
Medknow Publications & Media Pvt Ltd
Wolters Kluwer Medknow Publications
Subjects
Aged patients
Anesthesia
Arthroplasty
Cardiac arrhythmia
Cardiology
Cardiomyopathy, Hypertrophic
Care and treatment
Case Report
Elderly hypertrophic obstructive cardiomyopathy
femoral nerve block
General anesthesia
Heart rate
Intubation
Joint surgery
Knee
knee arthroplasty
Pain
Patient outcomes
Patient satisfaction
Physiological aspects
knee arthroplasty
Elderly hypertrophic obstructive cardiomyopathy
femoral nerve block
Online AccessGet full text

Cover

More Information
Summary:This case report exemplifies how the anaesthetic technique of general anesthesia with continuous bilateral femoral nerve block for bilateral knee arthroplasty was well chosen for the management of perioperative complications in an elderly patient with hypertrophic obstructive cardiomyopathy (HOCM). A 69-year-old female patient of HOCM was scheduled for bilateral total knee replacement. Echocardiography revealed severe left ventricular outflow tract obstruction with peak systolic gradient of 56 mmHg. The surgery was conducted under general anaesthesia with invasive monitoring and bilateral continuous femoral nerve blocks for postoperative analgesia. Postoperatively, she developed pulmonary oedema due to the liberal administration of fluids. This complication was successfully managed without interrupting the management of pain. Management of patients with HOCM for noncardiac surgery requires knowledge of variable presentation of two forms of disease. Also, this case report highlights the practical advantage of continuous femoral nerve block (CFNB)s over epidural anaesthesia.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0019-5049
0976-2817
DOI:10.4103/0019-5049.118566