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Published:
Oct 9, 2020DOI:
10.4314/rejhs.v8i3.7Keywords:
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Main Article Content
Anaesthetic Management of the Elderly with Low Ejection Fraction Undergoing Non-cardiac Surgery
Abstract
Low ejection fraction in the elderly presenting for anaesthesia could be very challenging to the anaesthetist on account of the heightened risk of perioperative complications. The combined risk of low ejection fraction and poor cardiac reserve may predispose to increase perioperative mortality. Complications in the perioperative period includes acute exacerbation of heart failure which can arise from pump failure or cardiac dyskinesia, and these could be debilitating in the elderly. Therefore, maintaining good systolic function and cardiac rhythm will ensure cardiovascular stability. We present the management of an 89year old man who had hypertensive heart disease with ejection fraction of 40% that successfully had dynamic hip replacement under combined spinal epidural (CSE) anaesthesia.
Keywords: neuraxial blockade, ejection fraction, elderly.
French title: Prise en charge anesthésique des âgées à faible taux d'éjection subissant une chirurgie non cardiaque
Une faible fraction d'éjection chez les âgées se présentant pour une anesthésie pourrait être très difficile pour l'anesthésiste en raison du risque accru de complications péri opératoires. Le risque combiné de faible fraction d'éjection et de faible réserve cardiaque peut prédisposer à une augmentation de la mortalité péri opératoire. Les complications de la période péri opératoire comprennent une exacerbation aiguë de l'insuffisance cardiaque qui peut résulter d'une défaillance de la pompe ou d'une dyskinésie cardiaque, et celles-ci pourraient être débilitantes chez les personnes âgées. Par conséquent, le maintien d'une bonne fonction systolique et d'un bon rythme cardiaque assurera la stabilité cardiovasculaire. Nous présentons la prise en charge d'un homme de 89 ans qui avait une cardiopathie hypertensive avec une fraction d'éjection de 40% qui a eu avec succès une arthroplastie dynamique de la hanche sous anesthésie épidurale rachidienne combinée (AERC).
Mots-clés : Blocage neuraxial, fraction d'éjection, personnes âgées
