The Use of Thoracic Segmental Spinal Anesthesia for a Thoracoscopic Diaphragmatic Hernia Repair in an Adult with Cardiac Compromise
Date
2024-04-01
Authors
Mahmoud Manasra
Omar Height
Rahaf Adwan
Mohammed Maraqa
Journal Title
Journal ISSN
Volume Title
Publisher
Deanship of Research/ Al-Quds University
Abstract
Morgagni hernia repair is commonly performed under general anesthesia (GA). While general anesthesia is becoming more and safer, there are still some dangers and problems; nevertheless, neuraxial anesthesia also has its risks and contraindications. The most frequent problems with general anesthesia are respiratory and cardiovascular in nature. Under GA, there is a chance of myocardial infarction, disruption of lung mechanics, and aggravation of preexisting comorbidities. Thoracic segmental spinal synesthesia (TSSA) is a type of regional anesthesia that could serve as an effective alternative to general anesthesia in patients who have contraindications for GA. This neuraxial anesthesia technique is especially useful for individuals receiving general anesthesia who are deemed to be at high risk (e.g., old age). Improved patient safety, a shorter length of stay in the post-anesthesia care unit, and better postoperative pain control are some benefits of using thoracic spinal anesthesia for these routine operations. For a number of surgical procedures, such as laparoscopic cholecystectomies, breast cancer lumpectomies, and abdominal cancer surgery, thoracic spinal anesthesia has been shown in the literature to be a safe and reliable technique. As far as we know, we provide the first documented instance of laparoscopic repair of an acquired Morgagni hernia using TSSA in an 80-year-old woman with HFrEF and other comorbidities.