Open AccessTransversus abdominis plane block for an emergency laparotomy in a high-risk, elderly patient
Author(s) -
Sandeep B. Patil,
S. Pawar,
VM Divekar,
Rochana G Bakhshi
Publication year - 2010
Publication title -
indian journal of anaesthesia/indian journal of anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.645
H-Index - 30
eISSN - 0976-2817
pISSN - 0019-5049
DOI - 10.4103/0019-5049.65377
Subject(s) - medicine , laparotomy , heart failure , furosemide , anesthesia , perforation , sedation , blood pressure , surgery , cardiology , materials science , punching , metallurgy
A 72-year-old male patient with gall bladder perforation and small intestinal obstruction from impacted gall stone was posted for emergency laparotomy. He had congestive heart failure, severe hypertension at admission and history of multiple other coexisting diseases. On admission, he developed pulmonary oedema from systolic hypertension which was controlled by ventilatory support, nitroglycerine and furosemide. Preoperative international normalized ratio was 2.34 and left ventricular ejection fraction was only 20%. Because of risk of exaggerated fall in blood pressure during induction of anaesthesia (general or neuraxial), a transversus abdominis plane block via combined Petit triangle and subcostal technique was administered and supplemented with Propofol sedation.