Abstract

Regional techniques are preferred to general anesthesia in lowerextremity surgery. Especially in elderly patients with high cardiac risk, the main objective is to supply sufficient anesthesia preserving hemodynamic stability. A 63-year-old female patient in whom emergency right leg amputation above the knee was planned, was treated for myocardial infarction without ST elevation 6 days ago. She had type 2 diabetes mellitus for 15 years, and hypertension for 10 years. She underwent a coronary bypass operation for two vessels and mitral annuloplasty two years ago and right leg amputation below the knee two months ago. An intrathecal cathater was placed at the right lateral position from L3-4 intervertebral space through the cathater by the needle technique. After cerebrospinal fluid flow was observed, we administered 2,5 mg 0.5% bupivacaine. Anesthesia was maintained by performing 2.5 mg of bupivacain every five minutes at a total dose of 7.5 mg until adequate sensory block was reached. The patient was given a supine positione after the sensory block reached T10 level. The patient was hemodynamically stable during the operation and did not require additional drug from the catheter. The patient was sent to the ward after removing spinal cathater at the end of a one hour operation. In conclusion, especially in old patients with high cardiac risk, we think that continuous spinal anesthesia should be the method of choice for anesthesia in lower-extremity surgery.