Open AccessHypobaric spinal anesthesia in a large ventral hernia
Author(s) -
Ignacio Armendáriz-Buil,
S Gil-Caballero,
M A Guibert-Bayona,
A M Martín-Rubio,
J M Vicente de Vera-Floristán,
J Del Río-Manterola
Publication year - 2019
Publication title -
anales del sistema sanitario de navarra
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.175
H-Index - 23
eISSN - 2340-3527
pISSN - 1137-6627
DOI - 10.23938/assn.0585
Subject(s) - medicine , anesthesia , fentanyl , respiratory system , airway , surgery , blockade , hernia , bupivacaine , neuromuscular blockade , receptor
High abdominal wall surgery may require general anesthesia but, in patients with high risk of difficult airway and respiratory complications, local or regional anesthesia is the choice whenever possible. Spinal anesthesia usually used (both isobaric and hyperbaric) could compromise the respiratory function due to blockade of the T6 metamere or higher. Hypobaric spinal anesthesia (HSA) at low doses (3.6 cc of 0.1% hypobaric bupivacaine plus 0.2 cc of 0.005% fentanyl) achieves sufficient analgesia with minimal motor blockade. We present the case of a patient with a large supraumbilical hernia with high risk of difficult airway and respiratory complications, who went through HSA. The patient did not report pain or dyspnea during the surgical procedure thus, HSA at low doses is an option to be taken into account in high abdominal wall surgery despite not having been described for this use.