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Canadian Journal of Anesthesia, Vol 33, 84-88, Copyright © 1986 by Canadian Anesthesiologists' Society

Epidural Analgesia for Total Hip Replacement in A Patient with Dilated Cardiomyopathy

L. AMARANATH MD1, SHAHPOUR ESFANDIARI MD1, JOHN LOCKREM MD1, and MICHAEL ROLLINS MD1

1 Departments of Anesthesiology, Surgical Intensive Care, and Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio

Address correspondence to: Dr. L. Amaranath, Cleveland Clinic Foundation, Division of Anesthesiology, 9500 Euclid Avenue, Cleveland, Ohio, 44106

A 69-year-old patient with severe impairment of left ventricular function secondary to dilated cardiomyopathy underwent a successful total hip replacement under epidural analgesia. Perioperative heart rate and mean arterial pressure were stable at an analgesic level up to the seventh thoracic dermatome, achieved with mepivacaine two per cent with epinephrine. Asymptomatic pulmonary hypertension, occurring during the insertion of the femoral prosthesis, subsided spontaneously over the next twelve hours. The circulatory effects of epidural analgesia and their significance in a patient with dilated cardiomyopathy are discussed.

Key Words: SURGERY: total hip replacement • ANAESTHETIC TECHNIQUES: epidural • HEART: dilated cardiomyopathy






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Copyright © 1986 by the Canadian Anesthesiologists' Society.