Short communication, Note

The use of an ultrasound-guided supraclavicular brachial plexus block in a high risk patient with cardiomyopathy

BARBARA PALKOVIĆ ; General Hospital Vinkovci, Department of Anesthesiology, Reanimatology and Intensive Care, Zvonarska 57, 32100 Vinkovci, Croatia
IVANA HARŠANJI DRENJANČEVIĆ ; Osijek University Hospital, Faculty of Medicine, University of Osijek, Department of Anesthesiology, Reanimatology and Intensive Care, Josipa Huttlera 4, 31000 Osijek, Croatia
DUBRAVKA IVIĆ ; Osijek University Hospital, Faculty of Medicine, University of Osijek, Department of Anesthesiology, Reanimatology and Intensive Care, Josipa Huttlera 4, 31000 Osijek, Croatia
SLAVICA KVOLIK ; Osijek University Hospital, Faculty of Medicine, University of Osijek, Department of Anesthesiology, Reanimatology and Intensive Care, Josipa Huttlera 4, 31000 Osijek, Croatia

Abstract

With the rapid growth of the elderly population, along with increased
comorbidities and greater life expectancy, geriatric surgery has become more frequent and requires careful tailoring of anesthesia technique. Preanesthetic evaluation should concentrate on the identification of age-related diseases and an estimation of physiological reserve. Age-related cardiovascular changes are leading factors impacting perioperative outcomes among elderly patients. The management of a patient with dilated cardiomyopathy, who undergoes a non-cardiac surgery is always a challenge for an anesthesiologist,
as this situation is associated with a high mortality rate.

We report a use of the ultrasound guided supraclavicular brachial plexus
block in 87-year old woman for revision of wound of left wrist and reposition and immobilization of left forearm and elbow. Her previous medical records revealed that she arterial hypertension, chronic atrial fibrillation with dilated cardiomyopathy and chronic kidney disease, stage II. Postoperatively, she developed respiratory insufficiency.

This case report exemplifies how despite all the measures and precaution
we had taken, with choosing anesthesia having only minimal hemodynamic
fluctuations and carefully planned and balanced hydration of patient we
still had unwanted outcome.

Keywords

Hrčak ID:

143073

URI

https://hrcak.srce.hr/143073

Publication date:

10.6.2015.

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