Thoracic epidural analgesia in a patient with multiple comorbidities for subxiphoid incisional hernia repair

ABSTRACT

Anesthetic preparation before non-cardiac surgery deserves particular attention in patients with cardiac disease as these are prone to develop hemodynamic instability and myocardial ischemia. Risk of complications is not only related to individual patient characteristics, but also to surgery related factors. In this report we present our experience regarding anesthetic management of a patient with multiple comorbidities including advanced chronic obstructive pulmonary disease, severely impaired left ventricular systolic function and occluded by pass grafts. We chose thoracic epidural analgesia for his subxiphoid incisional hernia repair. The operative and postoperative course was uneventful