Indian Journal of Anaesthesia  
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CASE REPORT
Year : 2010  |  Volume : 54  |  Issue : 3  |  Page : 249-254

Transversus abdominis plane block for an emergency laparotomy in a high-risk, elderly patient


Department of Anaesthesiology, Padmashree Dr. D.Y. Patil Medical College and Hospital Research Centre, Nerul, Navi-Mumbai, India

Correspondence Address:
Shonali C Pawar
Department of Anaesthesiology, Padmashree Dr. D.Y. Patil Hospital and Research Centre, Nerul, Navi-Mumbai - 400 706
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5049.65377

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A 72-year-old male patient with gall bladder perforation and small intestinal obstruction from impacted gall stone was posted for emergency laparotomy. He had congestive heart failure, severe hypertension at admission and history of multiple other coexisting diseases. On admission, he developed pulmonary oedema from systolic hypertension which was controlled by ventilatory support, nitroglycerine and furosemide. Preoperative international normalized ratio was 2.34 and left ventricular ejection fraction was only 20%. Because of risk of exaggerated fall in blood pressure during induction of anaesthesia (general or neuraxial), a transversus abdominis plane block via combined Petit triangle and subcostal technique was administered and supplemented with Propofol sedation.


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