Anesthetic management of a patient with hypertrophic obstructive cardiomyopathy under epidural anesthesia with high dose fentanyl
Okuyama, K.; Kashimoto, S.; Iwashita, H.; Kume, M.; Kumazawa, T.
Masui. Japanese Journal of Anesthesiology 42(9): 1363-1366
1993
ISSN/ISBN: 0021-4892 PMID: 8230728 Document Number: 409926
Hypertrophic obstructive cardiomyopathy (HOCM) is characterized by asymmetric hypertrophy of the intraventricular septum, causing intermittent obstruction of the left ventricular outflow tract. General principles of management of HOCM include maintenance of adequate preload and afterload, and avoidance of tachycardia and increased myocardial contractility. A 57 year old male for subtotal gastrectomy and gastrojejunostomy received epidural anesthesia with epidural high dose fentanyl (0.5 mg) and 0.5% isoflurane with N-2O and oxygen. Blood pressure and heart rate decreased mildly but were stable during the operation and during the recovery period from anesthesia without any complaints of pain. The results suggest that epidural high dose fentanyl anesthesia is a good method for patients with HOCM.