Anesthesia Strategies for the Perioperative Management of Severe Pulmonary Hypertension in Emergency Orthopedic Surgery: A Case Report

Authors

• Ejaz Khan, New York Medical College
• Shoaib Nawaz, New York Medical College
• Kiran Inam
• Malek Alali, New York Medical College
• Muhammad Waqas, New York Medical College

Author Type(s)

Faculty, Resident/Fellow

DOI

10.7759/cureus.68836

Journal Title

Cureus

First Page

68836

Last Page

68836

Document Type

Case Report

Publication Date

9-6-2024

Department

Anesthesiology

Keywords

pulmonary hypertension; anesthesia strategies; orthopedic surgery; perioperative care; spinal and epidural anesthesia

Disciplines

Medicine and Health Sciences

Abstract

This case report details the perioperative challenges and anesthesia strategies in managing severe pulmonary hypertension (PH) during emergency orthopedic surgery. An 86-year-old male with multiple comorbidities, including severe PH, presented with a hip fracture. Multidisciplinary collaboration was crucial for preoperative optimization, including transfusions, antithrombotic discontinuation, and thromboprophylaxis initiation. Anesthesia management included the use of spinal anesthesia combined with a precautionary epidural catheter insertion, low-dose hyperbaric bupivacaine, and continuous monitoring to prevent hemodynamic instability. Postoperatively, the patient was closely monitored in the surgical intensive care unit. This case highlights the necessity of meticulous planning and proactive monitoring in optimizing outcomes for severe PH in emergency orthopedic surgery.

Recommended Citation

Khan, E., Nawaz, S., Inam, K., Alali, M., & Waqas, M. (2024). Anesthesia Strategies for the Perioperative Management of Severe Pulmonary Hypertension in Emergency Orthopedic Surgery: A Case Report. Cureus, 16 (9), 68836-68836. https://doi.org/10.7759/cureus.68836