Abstract No.: ABS0617: Anaesthesia management of high risk cardiac patients for lower limb vascular surgeries

Abstract

Background and Aims:Managing Cardiac patients for noncardiac surgery is a daunting task. Haemodynamic disturbances during neuraxial blocks or general anesthesia may worsen the cardiac pathology. Peripheral nerve blocks can prove to be a better alternative in lower limb vascular surgeries.Methods:We included 25 high risk cardiac patients posted for lower limb vascular surgeries. Both lumbar plexus and sacral plexus blocks were performed. Haemodynamic monitoring and perioperative new cardiac events were recorded. Any additional supplementation of drugs was also noted.Results:Out of 25 patients, 75 patients were male and rest 25 were females. Two patients required additional supplementation with total intravenous anaesthesia. No haemodynamic instability was recorded (table 1). One patient died due to ventricular tachycardia 4 hours after surgery.Conclusion:Combined lumbar and sacral plexus blocks resulted as an alternative to neuroaxial blocks or general anaestheisa in patients of high cardiac risk patients undergoing lower limb vascular surgeries.Table 1Perioperative mean arterial blood pressure (MAP)Variation in MAP from baseline %Number of patientsDecrease by >20%0Decrease by 10-20%5Within 10% of baseline15Increase by 10-20%5Increase by >20%0