Unilateral Spinal Block in a Patient with Hypertrophic Cardiomyopathy with Left Ventricular Outflow Obstruction Undergoing Limb Surgery: A Case Report
Hypertrophic Cardiomyopathy (HOCM) is inherited cardiac disorder characterized by dynamic Left Ventricular Outflow Tract Obstruction (LVOT) at rest, during activity or in response to unpleasant stimuli. The decision to administer spinal anaesthesia in patients with HOCM and LVOTO remains controversial due to concerns regarding the effects on hemodynamics and potential exacerbation of LVOT. Due to technical difficulty to provide peripheral nerve block as well as risk of hemodynamic instability with bilateral sympathetic blockade in spinal anaesthesia, this case was planned in unilateral spinal block.
This case report shows that unilateral spinal block can be safe and effective alternative anaesthetic technique for patients diagnosed with HOCM with LVOTO undergoing lower limb surgery.
Yashoda Khadka*, Pooja Bhari, Pranisha Dotel