title: [Spinal anesthesia using a low dose of isobaric bupivacaine in a patient with pulmonary artery hypertension and mixed obstructive and restrictive lung disease undergoing repeated femoral fracture surgery].
abstract: A 75-year-old woman with primary pulmonary hypertension was on medical therapy and ambulatory oxygen inhalation therapy for 7 years. The patient had right femoral fracture and was admitted to our hospital. She had also suffered from asthma for 2 years, and her vital capacity was 1.35 l with forced expiratory volume in 1 second 0.79 l, and with her mean pulmonary artery pressure 60 mmHg. Open reduction and internal fixation were performed under spinal anesthesia using isobaric bupivacaine 6 mg with fentanyl 10 microg, and the patient was discharged on postoperative 31 day with no major complications. One year after the surgery, she had left femoral fracture, and surgery was performed under spinal anesthesia using isobaric bupivacaine 6 mg with fentanyl 10 microg. With its minimal effects on hemodynamics, we speculate that spinal anesthesia using a low dose of isobaric bupivacaine can be a choice for patients with pulmonary hypertension.
authors.affiliation: Department of Anesthesiology, Kyorin University, School of Medicine, Mitaka 181 8611.
authors.forename: Koji
authors.initials: K
authors.lastname: Uzawa
authors.affiliation: Department of Anesthesiology, Kyorin University, School of Medicine, Mitaka 181 8611.
authors.forename: Masako
authors.initials: M
authors.lastname: Hakone
authors.affiliation: Department of Anesthesiology, Kyorin University, School of Medicine, Mitaka 181 8611.
authors.forename: Harumasa
authors.initials: H
authors.lastname: Nakazawa
authors.affiliation: Department of Anesthesiology, Kyorin University, School of Medicine, Mitaka 181 8611.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yasuda
authors.affiliation: Department of Anesthesiology, Kyorin University, School of Medicine, Mitaka 181 8611.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Moriyama
authors.affiliation: Department of Anesthesiology, Kyorin University, School of Medicine, Mitaka 181 8611.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Yorozu
mesh_terms: D000368:Aged; D000775:Anesthesia, Spinal / Q000379:methods*; D002045:Bupivacaine / Q000008:administration & dosage*; D005260:Female; D005264:Femoral Fractures / Q000150:complications / Q000601:surgery*; D005541:Forced Expiratory Volume; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D008173:Lung Diseases, Obstructive / Q000150:complications* / Q000503:physiopathology; D016343:Monitoring, Intraoperative; D019637:Orthopedic Procedures; D010102:Oxygen Inhalation Therapy; D011183:Postoperative Complications / Q000517:prevention & control; D012086:Reoperation; D014797:Vital Capacity
chemical_list: D002045:Bupivacaine