[Regional anesthesia for patients with cardiac diseases]

Abstract

This review explores the effects of central neural blockade on cardiovascular system in healthy patients and for patients with common cardiovascular disease (ischemic heart disease, rheumatic valve disorders, cardiomyopathy). Central regional blockade poses these patients at some extent of risk due to possible hemodynamic instability because of effects of blockade on peripheral vessels and heart. High epidural anesthesia has favourable effects on coronary vessels. It increases diameter of epicardial coronary stenosis, reduces the ST segment depression, provides pain relief for patients with unstable angina, does not affect myocardial contractility. Recommendations are made about applying the central regional anesthesia for these patients; prevention and treatment of hypotension are discussed; and peculiarities of central regional anesthesia for patients taking anticoagulants are highlighted.