Successful Use of Continuous Erector Spinae Plane Blocks in a Patient With Variant Angina After Large Ventral Hernia Repair
Coronary artery spasm constitutes the primary underlying pathology of variant angina. Because provocation of coronary artery spasm may occur with both excess sympathetic and excess parasympathetic stimulation, patients with this disorder have extremely limited options for perioperative pain control....
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Veröffentlicht in: | Texas Heart Institute journal 2022-11, Vol.49 (6) |
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creator | Belfar, Alexandra L Deng, Yi Yu, Raymond C Sabbagh, Annas |
description | Coronary artery spasm constitutes the primary underlying pathology of variant angina. Because provocation of coronary artery spasm may occur with both excess sympathetic and excess parasympathetic stimulation, patients with this disorder have extremely limited options for perioperative pain control. This is especially true for procedures involving extensive abdominal incision/manipulation. Whereas neuraxial analgesia might otherwise be appropriate in these cases, several studies have demonstrated that coronary artery spasm can occur as a result of epidural placement, and therefore, that this may not be an optimal choice for patients with variant angina. This report discusses the case of a patient with a preexisting diagnosis of variant angina who underwent an exploratory laparotomy with large ventral hernia repair and for whom continuous erector spinae plane blocks were successfully used as analgesic adjuncts without triggering coronary artery spasm. |
doi_str_mv | 10.14503/THIJ-21-7624 |
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Because provocation of coronary artery spasm may occur with both excess sympathetic and excess parasympathetic stimulation, patients with this disorder have extremely limited options for perioperative pain control. This is especially true for procedures involving extensive abdominal incision/manipulation. Whereas neuraxial analgesia might otherwise be appropriate in these cases, several studies have demonstrated that coronary artery spasm can occur as a result of epidural placement, and therefore, that this may not be an optimal choice for patients with variant angina. This report discusses the case of a patient with a preexisting diagnosis of variant angina who underwent an exploratory laparotomy with large ventral hernia repair and for whom continuous erector spinae plane blocks were successfully used as analgesic adjuncts without triggering coronary artery spasm.</description><identifier>ISSN: 0730-2347</identifier><identifier>EISSN: 1526-6702</identifier><identifier>DOI: 10.14503/THIJ-21-7624</identifier><identifier>PMID: 36534113</identifier><language>eng</language><publisher>United States: Texas Heart® Institute, Houston</publisher><subject>Angina Pectoris, Variant - diagnosis ; Case Reports ; Coronary Vasospasm ; Hernia, Ventral ; Humans ; Nerve Block</subject><ispartof>Texas Heart Institute journal, 2022-11, Vol.49 (6)</ispartof><rights>2022 by the Texas Heart® Institute, Houston.</rights><rights>2022 by the Texas Heart Institute, Houston 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c343t-5404e42c4cb019cad3a3ce8ab7d1ca5217786e4ac664a0fbf06c07e8b0992323</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9809071/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9809071/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36534113$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Belfar, Alexandra L</creatorcontrib><creatorcontrib>Deng, Yi</creatorcontrib><creatorcontrib>Yu, Raymond C</creatorcontrib><creatorcontrib>Sabbagh, Annas</creatorcontrib><title>Successful Use of Continuous Erector Spinae Plane Blocks in a Patient With Variant Angina After Large Ventral Hernia Repair</title><title>Texas Heart Institute journal</title><addtitle>Tex Heart Inst J</addtitle><description>Coronary artery spasm constitutes the primary underlying pathology of variant angina. Because provocation of coronary artery spasm may occur with both excess sympathetic and excess parasympathetic stimulation, patients with this disorder have extremely limited options for perioperative pain control. This is especially true for procedures involving extensive abdominal incision/manipulation. Whereas neuraxial analgesia might otherwise be appropriate in these cases, several studies have demonstrated that coronary artery spasm can occur as a result of epidural placement, and therefore, that this may not be an optimal choice for patients with variant angina. This report discusses the case of a patient with a preexisting diagnosis of variant angina who underwent an exploratory laparotomy with large ventral hernia repair and for whom continuous erector spinae plane blocks were successfully used as analgesic adjuncts without triggering coronary artery spasm.</description><subject>Angina Pectoris, Variant - diagnosis</subject><subject>Case Reports</subject><subject>Coronary Vasospasm</subject><subject>Hernia, Ventral</subject><subject>Humans</subject><subject>Nerve Block</subject><issn>0730-2347</issn><issn>1526-6702</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkc1vEzEQxS0EoqFw5Ip85LIw_lh794IUotIURWpFQzlas85sath4g71bCfHPsyGloqfRaH568_QeY68FvBO6BPV-vbz4XEhRWCP1EzYTpTSFsSCfshlYBYVU2p6wFzl_BwAlhXzOTpQplRZCzdjv69F7yrkdO_41E-9bvujjEOLYj5mfJfJDn_j1PkQkftVhJP6x6_2PzEPkyK9wCBQH_i0Mt_wGU8BpmcfthPN5O1DiK0xb4jcTlLDjS0oxIP9CewzpJXvWYpfp1f08ZetPZ-vFslhdnl8s5qvCK62GotSgSUuvfQOi9rhRqDxV2NiN8FhKYW1lSKM3RiO0TQvGg6WqgbqWSqpT9uEoux-bHW380Yrbp7DD9Mv1GNzjSwy3btvfubqCGqyYBN7eC6T-50h5cLuQPXWHNKaUnLRlWYEwSk1ocUR96nNO1D68EeD-9uUOfTkp3KGviX_zv7cH-l9B6g8_DZJN</recordid><startdate>20221101</startdate><enddate>20221101</enddate><creator>Belfar, Alexandra L</creator><creator>Deng, Yi</creator><creator>Yu, Raymond C</creator><creator>Sabbagh, Annas</creator><general>Texas Heart® Institute, Houston</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20221101</creationdate><title>Successful Use of Continuous Erector Spinae Plane Blocks in a Patient With Variant Angina After Large Ventral Hernia Repair</title><author>Belfar, Alexandra L ; Deng, Yi ; Yu, Raymond C ; Sabbagh, Annas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c343t-5404e42c4cb019cad3a3ce8ab7d1ca5217786e4ac664a0fbf06c07e8b0992323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Angina Pectoris, Variant - diagnosis</topic><topic>Case Reports</topic><topic>Coronary Vasospasm</topic><topic>Hernia, Ventral</topic><topic>Humans</topic><topic>Nerve Block</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Belfar, Alexandra L</creatorcontrib><creatorcontrib>Deng, Yi</creatorcontrib><creatorcontrib>Yu, Raymond C</creatorcontrib><creatorcontrib>Sabbagh, Annas</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Texas Heart Institute journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Belfar, Alexandra L</au><au>Deng, Yi</au><au>Yu, Raymond C</au><au>Sabbagh, Annas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Successful Use of Continuous Erector Spinae Plane Blocks in a Patient With Variant Angina After Large Ventral Hernia Repair</atitle><jtitle>Texas Heart Institute journal</jtitle><addtitle>Tex Heart Inst J</addtitle><date>2022-11-01</date><risdate>2022</risdate><volume>49</volume><issue>6</issue><issn>0730-2347</issn><eissn>1526-6702</eissn><abstract>Coronary artery spasm constitutes the primary underlying pathology of variant angina. Because provocation of coronary artery spasm may occur with both excess sympathetic and excess parasympathetic stimulation, patients with this disorder have extremely limited options for perioperative pain control. This is especially true for procedures involving extensive abdominal incision/manipulation. Whereas neuraxial analgesia might otherwise be appropriate in these cases, several studies have demonstrated that coronary artery spasm can occur as a result of epidural placement, and therefore, that this may not be an optimal choice for patients with variant angina. This report discusses the case of a patient with a preexisting diagnosis of variant angina who underwent an exploratory laparotomy with large ventral hernia repair and for whom continuous erector spinae plane blocks were successfully used as analgesic adjuncts without triggering coronary artery spasm.</abstract><cop>United States</cop><pub>Texas Heart® Institute, Houston</pub><pmid>36534113</pmid><doi>10.14503/THIJ-21-7624</doi><oa>free_for_read</oa></addata></record> |
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subjects | Angina Pectoris, Variant - diagnosis Case Reports Coronary Vasospasm Hernia, Ventral Humans Nerve Block |
title | Successful Use of Continuous Erector Spinae Plane Blocks in a Patient With Variant Angina After Large Ventral Hernia Repair |
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