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[Spinal anesthesia for an emergency surgery in a patient with right sided heart failure]
1Department of Anesthesiology, Daiichi Hospital, Nippon Medical School, Tokyo.
Abstract:
A 79-year-old female with a pace maker implanted because of complete A-V block associated with right sided heart failure was scheduled for the emergency repair of incarcerated abdominal wall hernia. Spinal anesthesia for the surgery and epidural catheterization for postoperative pain control were performed. Anesthesia and postoperative course were uneventful. The effects of spinal anesthesia on cardiovascular system are the result of preganglionic sympathetic block produced by the local anesthetic agent injected in the subarachnoid space. It is, therefore, desirable to consider the cardiovascular effects of spinal anesthesia (reduction of afterload and preload) on a patient who has right sided heart failure. Post operative pain control by PCA pump is also a basic method for a patient with right sided heart failure.