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[Peridural anesthesia for subcostal cholecystectomy in patients with dilated cardiomyopathy. Apropos of 2 cases]
1Servicio de Anestesiología y Reanimación, Hospital Clínic i Provincial, Barcelona.
Insights
Epidural anesthesia is a safe option for patients with dilated cardiomyopathy (DCM) undergoing subcostal cholecystectomy. This approach maintained hemodynamic stability and avoided complications in two high-risk surgical patients.
Area of Science:
- Cardiology
- Anesthesiology
- Surgical Oncology
Background:
- Dilated cardiomyopathy (DCM) presents significant anesthetic risks.
- Anesthetic technique selection is critical for high-risk patients with DCM.
- Patient comorbidities, including alcohol use and ischemia, complicate anesthetic management.
Observation:
- Two patients with DCM underwent subcostal cholecystectomy.
- Epidural anesthesia was administered to both patients.
- Both patients had histories of DCM, one related to alcohol use and the other to ischemia.
Findings:
- Patients remained hemodynamically stable throughout the surgery.
- No intraoperative or postoperative complications occurred.
- Successful surgical outcomes were achieved with epidural anesthesia.
Implications:
- Epidural anesthesia offers a viable alternative to general anesthesia for DCM patients undergoing specific surgical procedures.
- This approach may reduce anesthetic risks in high-risk cardiac patients.
- Further research into anesthetic strategies for DCM patients is warranted.
Abstract:
Two patients with dilated cardiomyopathy (DCM) were considered to be at high risk for anesthesia and surgery due to possible complications during and after surgery. The anesthetic technique used in such cases must be selected based on the type of surgery and the severity of heart disease. We describe the cases of 2 patients with histories of DCM, arising in a context of alcohol use in one case and of ischemia in the other. The patients were scheduled for uncomplicated cholecystectomy by subcostal approach under epidural anesthesia. The patients remained hemodynamically stable during surgery and there were no complications. They were released 26 and 13 days after surgery, respectively. We conclude that epidural anesthesia is a valid alternative to general anesthesia in DCM patients undergoing subcostal cholecystectomy.