Use of combined spinal epidural anaesthesia (CSEA) with epidural volume expansion (EVE) technique in patients with poor left ventricle (LV) function and assessment of hemodynamic stability

摘要

Giving anaesthesia in a patient having poor Left Ventricle (LV) function has always been very challenging to anaesthesiologists. In our present study we used CSEA (combined spinal epidural anaesthesia) with EVE (epidural volume expansion) technique for patients undergoing lower abdominal surgery with poor LV function. In our study, intrathecally low dose 0.5% heavy bupivacaine (7.5mg) was combined with EVE technique followed by epidural top up. The desired level of block was up to T-4. Following institution of anaesthesia in the above manner, we assessed the various hemodynamic variables (H.R., Systolic Diastolic and Mean Blood Pressure) in the perioperative period at various time points. During statistical analysis we compared the preoperative values with the values at various time points using student's paired't' test and found that p value was less than 0.05 suggesting that hemodynamic changes were insignificant. So we concluded that this method of anaesthesia can be useful option/ alternative in patients with poor LV function undergoing lower abdominal surgeries.