Anesthetic Approach To The Candidate For Heart Transplant To Undergo Tur-M

Saddle block is an ideal procedure that can provide sufficient anesthesia by protecting hemodynamic stability especially in elder patients with high cardiac risk. A 52 years old male patient with bladder tumor who was scheduled for transurethral bladder resection (TUR-B) had history of hypertension, diabetes mellitus and congestive heart failure. Echocardiography showed that LVEF was 20%; RVEF was 28% and there were insufficiency (MVI) of third degree, insufficiency (TVI) of second degree, biventricular global hypokinesia and remarkable dilatation on the right and left structures of the heart. The patient was considered as having ASA class IV. He had TUR-B under saddle block. In conclusion, we considered that saddle blockade was a more safe and efficient anesthetic procedure rather than neuroaxial blockade or general anesthesia for the highrisk patient who had bladder tumor.