Spinal Anesthesia Using Ultra-Low-Dose Isobaric Bupivacaine with Intrathecal Morphine-Fentanyl for Bilateral Low Extremity Procedures in a Geriatric Patient with Recent Myocardial Infarction and Percutaneous Coronary Intervention

A recent inferior ST-elevation myocardial infarction and percutaneous coronary intervention in an elderly female patient scheduled for bilateral lower extremity operations simultaneously represent significant risks for re-infarction and mortality. Our index patient required an above-knee amputation...

Descripción completa

Detalles Bibliográficos
Autores principales: Rukewe, Ambrose, Nanyalo-Nashima, Linea, Olivier, Nicola
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7837540/
https://www.ncbi.nlm.nih.gov/pubmed/33519232
http://dx.doi.org/10.2147/LRA.S287975
_version_ 1783642974316396544
author Rukewe, Ambrose
Nanyalo-Nashima, Linea
Olivier, Nicola
author_facet Rukewe, Ambrose
Nanyalo-Nashima, Linea
Olivier, Nicola
author_sort Rukewe, Ambrose
collection PubMed
description A recent inferior ST-elevation myocardial infarction and percutaneous coronary intervention in an elderly female patient scheduled for bilateral lower extremity operations simultaneously represent significant risks for re-infarction and mortality. Our index patient required an above-knee amputation of the left leg to prevent infection/progressing gangrene as well as application of a back-slab for the conservative management of a fractured right femur. We employed spinal injection of ultra-low-dose 0.5% isobaric bupivacaine 4 mg with morphine 75 mcg plus fentanyl 10 mcg which provided adequate anesthesia for radical amputation, effective postoperative analgesia and good hemodynamic stability.
format Online
Article
Text
id pubmed-7837540
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Dove
record_format MEDLINE/PubMed
spelling pubmed-78375402021-01-28 Spinal Anesthesia Using Ultra-Low-Dose Isobaric Bupivacaine with Intrathecal Morphine-Fentanyl for Bilateral Low Extremity Procedures in a Geriatric Patient with Recent Myocardial Infarction and Percutaneous Coronary Intervention Rukewe, Ambrose Nanyalo-Nashima, Linea Olivier, Nicola Local Reg Anesth Case Report A recent inferior ST-elevation myocardial infarction and percutaneous coronary intervention in an elderly female patient scheduled for bilateral lower extremity operations simultaneously represent significant risks for re-infarction and mortality. Our index patient required an above-knee amputation of the left leg to prevent infection/progressing gangrene as well as application of a back-slab for the conservative management of a fractured right femur. We employed spinal injection of ultra-low-dose 0.5% isobaric bupivacaine 4 mg with morphine 75 mcg plus fentanyl 10 mcg which provided adequate anesthesia for radical amputation, effective postoperative analgesia and good hemodynamic stability. Dove 2021-01-22 /pmc/articles/PMC7837540/ /pubmed/33519232 http://dx.doi.org/10.2147/LRA.S287975 Text en © 2021 Rukewe et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Case Report
Rukewe, Ambrose
Nanyalo-Nashima, Linea
Olivier, Nicola
Spinal Anesthesia Using Ultra-Low-Dose Isobaric Bupivacaine with Intrathecal Morphine-Fentanyl for Bilateral Low Extremity Procedures in a Geriatric Patient with Recent Myocardial Infarction and Percutaneous Coronary Intervention
title Spinal Anesthesia Using Ultra-Low-Dose Isobaric Bupivacaine with Intrathecal Morphine-Fentanyl for Bilateral Low Extremity Procedures in a Geriatric Patient with Recent Myocardial Infarction and Percutaneous Coronary Intervention
title_full Spinal Anesthesia Using Ultra-Low-Dose Isobaric Bupivacaine with Intrathecal Morphine-Fentanyl for Bilateral Low Extremity Procedures in a Geriatric Patient with Recent Myocardial Infarction and Percutaneous Coronary Intervention
title_fullStr Spinal Anesthesia Using Ultra-Low-Dose Isobaric Bupivacaine with Intrathecal Morphine-Fentanyl for Bilateral Low Extremity Procedures in a Geriatric Patient with Recent Myocardial Infarction and Percutaneous Coronary Intervention
title_full_unstemmed Spinal Anesthesia Using Ultra-Low-Dose Isobaric Bupivacaine with Intrathecal Morphine-Fentanyl for Bilateral Low Extremity Procedures in a Geriatric Patient with Recent Myocardial Infarction and Percutaneous Coronary Intervention
title_short Spinal Anesthesia Using Ultra-Low-Dose Isobaric Bupivacaine with Intrathecal Morphine-Fentanyl for Bilateral Low Extremity Procedures in a Geriatric Patient with Recent Myocardial Infarction and Percutaneous Coronary Intervention
title_sort spinal anesthesia using ultra-low-dose isobaric bupivacaine with intrathecal morphine-fentanyl for bilateral low extremity procedures in a geriatric patient with recent myocardial infarction and percutaneous coronary intervention
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7837540/
https://www.ncbi.nlm.nih.gov/pubmed/33519232
http://dx.doi.org/10.2147/LRA.S287975
work_keys_str_mv AT rukeweambrose spinalanesthesiausingultralowdoseisobaricbupivacainewithintrathecalmorphinefentanylforbilaterallowextremityproceduresinageriatricpatientwithrecentmyocardialinfarctionandpercutaneouscoronaryintervention
AT nanyalonashimalinea spinalanesthesiausingultralowdoseisobaricbupivacainewithintrathecalmorphinefentanylforbilaterallowextremityproceduresinageriatricpatientwithrecentmyocardialinfarctionandpercutaneouscoronaryintervention
AT oliviernicola spinalanesthesiausingultralowdoseisobaricbupivacainewithintrathecalmorphinefentanylforbilaterallowextremityproceduresinageriatricpatientwithrecentmyocardialinfarctionandpercutaneouscoronaryintervention

Ejemplares similares