Anaesthetic management of patient with Ischaemic Heart Disease with 25% ejection fraction for Urethroplasty

Dr. Pranita Kate; Dr. (col) V.R.R Chari; Dr. Jateen Amonkar; Dr. Ankit Sawhney; Dr. Arnab Paul

Volume : VI, Issue : I, January - 2017

Anaesthetic management of patient with Ischaemic Heart Disease with 25% ejection fraction for Urethroplasty

Dr. Pranita Kate, Dr. Col V. R. R Chari, Dr. Jateen Amonkar, Dr. Ankit Sawhney, Dr. Arnab Paul

Abstract :

Administering anaesthesia to cardiac patients for non cardiac surgery has always been challenging. The ultimate goal of anaesthesia in these patients to avoid ischaemia by balancing myocardial oxygen demand and supply. Preoperative assessment of risk factors, cardiovascular examination, preoperative evaluation and optimization is required for ischaemic heart disease patients. We need to select appropriate anaesthetic technique and drugs to improve patient�s outcome. Though the choice of anaesthesia has been general anaesthesia to achieve goal of greater myocardial oxygen supply than demand, in this case we decided to give lower segment epidural block for anaesthesia and post operative analgesia. We used Ropivacaine 0.75% for loading dose and 0.5% Ropivacaine for maintenance keeping haemodynamics stable. We report a successful anaesthetic management of a patient with ischaemic heart disease for urethroplasty under epidural anaesthesia and analgesia.