A Case of Optimizing Anesthetic Management for an Elderly Patient with Severe Left Ventricular Dysfunction Through a Multi-disciplinary Treatment Approach

Abstract

This case report presents a multi-disciplinary treatment (MDT) approach to optimize anesthetic management for an elderly patient with a giant inguinal hernia and severe left ventricular dysfunction. The patient, a 68-year-old male, had a 30-year history of a large inguinal hernia and was diagnosed with left ventricular hypertrophy and cardiac insufficiency, with an ejection fraction of 24%. Given the patient's complex comorbidities and the risks associated with anesthesia, a MDT was formed to develop a personalized treatment plan. The team included gastrointestinal surgeons, anesthesiologists, cardiovascular specialists, and intensive care physicians who collaborated to mitigate perioperative risks. The MDT strategy involved continuing preoperative cardiovascular medications, selecting anesthesia techniques to minimize impact, and maintaining strict fluid management during surgery. The patient underwent a successful tension-free repair of the inguinal hernia with the aid of an ultrasound-guided nerve block and local infiltration anesthesia. Throughout the procedure, vital signs remained stable, and the patient experienced no discomfort or complications related to anesthesia. The patient recovered well and was discharged after five days. The effectiveness of MDT in overseeing the care of elderly patients with high-risk conditions throughout the perioperative anesthesia phase is underscored. It underscores the importance of a collaborative approach to ensure patient safety and optimal outcomes in complex surgical cases. The MDT framework helps to prevent treatment deviations and delays, reducing patient anxiety and improving the overall quality of care.