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Neuraxial anesthesia for patients with severe pulmonary arterial hypertension undergoing urgent open abdominal surgeries: two case reports

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Title: Neuraxial anesthesia for patients with severe pulmonary arterial hypertension undergoing urgent open abdominal surgeries: two case reports
Authors: Shuhei Yamada, Yoshiaki Takise, Yuri Sekiya, Yuya Masuda, Yoshi Misonoo, Kenta Wakaizumi, Tomohiro Suhara, Hiroshi Morisaki, Jungo Kato, Takashige Yamada
Source: JA Clinical Reports, Vol 10, Iss 1, Pp 1-6 (2024)
Publisher Information: SpringerOpen, 2024.
Publication Year: 2024
Collection: LCC:Anesthesiology
LCC:Medical emergencies. Critical care. Intensive care. First aid
Subject Terms: Pulmonary hypertension, Adult congenital heart disease, Noncardiac surgery, Neuraxial anesthesia, Anesthesiology, RD78.3-87.3, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
More Details: Abstract Background There is no consensus regarding the choice of anesthetic method for patients with pulmonary hypertension (PH). We report two cases in which neuraxial anesthesia was safely performed without general anesthesia during open abdominal surgery in patients with severe PH. Case presentation Case 1: A 59-year-old woman had an atrial septal defect and a huge abdominal tumor with a mean pulmonary arterial pressure (PAP) of 39 mmHg and pulmonary vascular resistance (PVR) of 3.5 Wood units. Case 2: A 23-year-old woman who had hereditary pulmonary artery hypertension (mean PAP, 65 mmHg; PVR, 16.45 Wood units). Both patients underwent open abdominal surgery under neuraxial anesthesia without circulatory collapse with intraoperative administration of vasoconstrictors. Conclusion Although anesthetic care must be personalized depending on the pathology and severity of PH, neuraxial anesthesia may be an option for patients with severe PH undergoing abdominal surgery.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2363-9024
Relation: https://doaj.org/toc/2363-9024
DOI: 10.1186/s40981-024-00737-w
Access URL: https://doaj.org/article/e01eaf9500054a99a76b86979f27f445
Accession Number: edsdoj.01eaf9500054a99a76b86979f27f445
Database: Directory of Open Access Journals
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  Data: Neuraxial anesthesia for patients with severe pulmonary arterial hypertension undergoing urgent open abdominal surgeries: two case reports
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  Data: <searchLink fieldCode="AR" term="%22Shuhei+Yamada%22">Shuhei Yamada</searchLink><br /><searchLink fieldCode="AR" term="%22Yoshiaki+Takise%22">Yoshiaki Takise</searchLink><br /><searchLink fieldCode="AR" term="%22Yuri+Sekiya%22">Yuri Sekiya</searchLink><br /><searchLink fieldCode="AR" term="%22Yuya+Masuda%22">Yuya Masuda</searchLink><br /><searchLink fieldCode="AR" term="%22Yoshi+Misonoo%22">Yoshi Misonoo</searchLink><br /><searchLink fieldCode="AR" term="%22Kenta+Wakaizumi%22">Kenta Wakaizumi</searchLink><br /><searchLink fieldCode="AR" term="%22Tomohiro+Suhara%22">Tomohiro Suhara</searchLink><br /><searchLink fieldCode="AR" term="%22Hiroshi+Morisaki%22">Hiroshi Morisaki</searchLink><br /><searchLink fieldCode="AR" term="%22Jungo+Kato%22">Jungo Kato</searchLink><br /><searchLink fieldCode="AR" term="%22Takashige+Yamada%22">Takashige Yamada</searchLink>
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  Data: JA Clinical Reports, Vol 10, Iss 1, Pp 1-6 (2024)
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  Data: LCC:Anesthesiology<br />LCC:Medical emergencies. Critical care. Intensive care. First aid
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  Data: <searchLink fieldCode="DE" term="%22Pulmonary+hypertension%22">Pulmonary hypertension</searchLink><br /><searchLink fieldCode="DE" term="%22Adult+congenital+heart+disease%22">Adult congenital heart disease</searchLink><br /><searchLink fieldCode="DE" term="%22Noncardiac+surgery%22">Noncardiac surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Neuraxial+anesthesia%22">Neuraxial anesthesia</searchLink><br /><searchLink fieldCode="DE" term="%22Anesthesiology%22">Anesthesiology</searchLink><br /><searchLink fieldCode="DE" term="%22RD78%2E3-87%2E3%22">RD78.3-87.3</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+emergencies%2E+Critical+care%2E+Intensive+care%2E+First+aid%22">Medical emergencies. Critical care. Intensive care. First aid</searchLink><br /><searchLink fieldCode="DE" term="%22RC86-88%2E9%22">RC86-88.9</searchLink>
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  Data: Abstract Background There is no consensus regarding the choice of anesthetic method for patients with pulmonary hypertension (PH). We report two cases in which neuraxial anesthesia was safely performed without general anesthesia during open abdominal surgery in patients with severe PH. Case presentation Case 1: A 59-year-old woman had an atrial septal defect and a huge abdominal tumor with a mean pulmonary arterial pressure (PAP) of 39 mmHg and pulmonary vascular resistance (PVR) of 3.5 Wood units. Case 2: A 23-year-old woman who had hereditary pulmonary artery hypertension (mean PAP, 65 mmHg; PVR, 16.45 Wood units). Both patients underwent open abdominal surgery under neuraxial anesthesia without circulatory collapse with intraoperative administration of vasoconstrictors. Conclusion Although anesthetic care must be personalized depending on the pathology and severity of PH, neuraxial anesthesia may be an option for patients with severe PH undergoing abdominal surgery.
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      – Text: English
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    Subjects:
      – SubjectFull: Pulmonary hypertension
        Type: general
      – SubjectFull: Adult congenital heart disease
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