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Neuraxial Anesthesia in High-Risk Cardiac Patients

  • Regional Anesthesia (P Kukreja, Section Editor)
  • Published:
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Abstract

Purpose of Review

This review of neuraxial anesthesia in high-risk cardiac patients aims to delineate current best practices and highlight emerging themes in the literature.

Recent Findings

Pregnancy, especially in the presence of cardiac comorbidities, poses a unique set of challenges for anesthesiologists and obstetricians. Vaginal delivery, with good neuraxial anesthesia, is usually the preferred mode of delivery in women with cardiac disease, although the rate of cesarean delivery is higher among women with heart disease. For obstetric procedures, recent case reports have demonstrated the safety of neuraxial anesthesia in high-risk cardiac patients, though providers necessitate a careful balance between adequate neuraxial anesthesia and hemodynamic compromise.

Summary

Neuraxial anesthesia, including epidural and spinal techniques, has become a cornerstone in the management of labor pain and cesarean deliveries. However, its application in high-risk cardiac pregnant patients demands a careful consideration of potential risks and benefits.

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Data Availability

No datasets were generated or analysed during the current study.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Department of Anesthesiology and Perioperative Medicine, Division of Obstetric Anesthesia, University of Alabama at Birmingham, Birmingham, AL, USA

    Hanna Hussey & Annalese Neuenswander

  2. Department of Anesthesiology and Perioperative Medicine, Division of Cardiothoracic Anesthesia, University of Alabama at Birmingham, Birmingham, AL, USA

    Jacob B. Meers, Benjamin Tuck & Patrick Hussey

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  1. Hanna Hussey
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  5. Patrick Hussey
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Contributions

H.H. and P.H. wrote the main manuscript text. B.T. created the table. All authors reviewed and edited the manuscript.

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Correspondence to Patrick Hussey.

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Hussey, H., Neuenswander, A., Meers, J.B. et al. Neuraxial Anesthesia in High-Risk Cardiac Patients. Curr Anesthesiol Rep 14, 75–82 (2024). https://doi.org/10.1007/s40140-023-00593-x

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