Why the study?
Patients with cardiac disease undergoing non-cardiac surgery are at increased risk of perioperative cardiovascular events including myocardial ischemia and MI, with geriatric patients presenting significant anesthetic challenges.
Does graded epidural anesthesia provide safe perioperative management in an elderly patient with ischemic heart disease and reduced LVEF undergoing open cholecystectomy?
Does graded epidural anesthesia provide safe perioperative management in an elderly patient with ischemic heart disease and reduced LVEF undergoing open cholecystectomy?
Graded epidural anesthesia can be a safe and effective technique for managing high-risk elderly patients with ischemic heart disease and reduced ejection fraction undergoing major abdominal surgery.
Emphasizes perioperative CV risk management in post-MI geriatric patients; leaves open optimal protocols for similar noncardiac cases.
Geriatric patients with a limited physiological reserve and associated comorbidities present a challenge to anesthesiologists. Patients with cardiac disease coming for non-cardiac surgical procedures are at increased risk of perioperative cardiovascular events such as myocardial ischemia, myocardial infarction (MI) and are associated with greater morbidity and mortality. In this case report, the patient had a previous history of MI and was a known case of diabetes mellitus with acute cholecystitis with cholelithiasis with anterolateral ischemic heart disease with an ejection fraction of 35%. This patient was posted for open cholecystectomy with CBD exploration and successfully managed under graded epidural anesthesia and had an uneventful recovery.
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Parveen et al. (2021) studied this question.
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