Intrathecal Catheter for Urgent Hip Surgery in Two Patients with Severe Aortic Stenosis

Aortic stenosis (AS) is a common lesion of the aortic valve that places patients at higher risk of perioperative cardiovascular events [1] and can pose an intraoperative challenge to anesthesiologists.

 The lesion is characterized by left ventricular outflow obstruction with subsequent left ventricular hypertrophy and increased myocardial oxygen demand.

 Because of the peripheral sympathectomy caused by neuraxial anesthesia with resultant decrease in SVR and preload, these techniques have traditionally been considered contraindicated in these patients [2].

 However, general anesthesia (GA) can also cause significant hemodynamic fluctuations, and neuraxial anesthesia has been found to have benefits over GA in patient populations such as those undergoing hip surgery [3]. 

Here we describe the successful use of continuous intrathecal anesthesia in two severe AS patients undergoing orthopedic surgery.