Successful Use of Ultrasound Guided Quadratus Lumborum Block Without General Anesthesia for Open Appendectomy in a Patient with Heart Failure with Reduced Ejection Fraction- A Case Report and Literature Review

Dove Press 2024-02-23

Muhammad Jaffar Khan, Yasir Eltayeb, Arunabha Karmakar, Rohma Malik, Tarig Elsafi Department of Anesthesiology, Critical Care and Perioperative Medicine, Hamad Medical Corporation, Doha, QatarCorrespondence: Muhammad Jaffar Khan, Department of Anesthesiology, Critical Care and Perioperative Medicine, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar, Tel +97444394444, Email mkhan44@hamad.qaBackground: Patients diagnosed with Heart Failure with Reduced Ejection Fraction (HFrEF) are at high risk of perioperative cardiovascular complications. While it is important to focus on optimizing their cardiac function, it is also crucial to address and optimize any other modifiable risk factors that could potentially impact postoperative outcome. This also includes careful consideration of anesthetic techniques to suit the patient and facilitate the surgery. However, there is a scarcity of evidence regarding the safety of specific anesthetic approaches for heart failure patients.Case Presentation: We describe the case of an adult patient in mid-50s, with a history of ischemic dilated cardiomyopathy with reduced Ejection Fraction (about 25%) who presented with acute gangrenous appendicitis and was scheduled for an open appendectomy. It was deemed to be a high-risk patient for general and spinal anesthesia. With the guidance of a multidisciplinary team, surgery was successfully performed using a quadratus lumborum block with standard monitoring. The patient was comfortable and hemodynamically stable throughout the procedure. The postoperative course was uneventful.Conclusion: Quadratus Lumborum Block for open appendectomy can be a beneficial alternative anesthesia technique in high-risk patients that significantly lowers perioperative cardiovascular risk, maintains hemodynamics, enhances satisfaction, and shortens hospital stay.Keywords: quadratus lumborum block, regional anesthesia, heart failure with reduced ejection fraction, left ventricular ejection fraction, quadratus l

Local and Regional Anesthesia; Case report; info:eu-repo/semantics/article

Open access content. Open access content
info:eu-repo/semantics/openAccess

text/html
English

NZDMP oai:dovepress.com/90661
1428238652

DOVE MEDL PRESS LTD
From OAIster®, provided by the OCLC Cooperative.

edsoai.on1428238652