Thoracic epidural analgesia in a patient with multiple comorbidities for subxiphoid incisional hernia repair

Anesthetic preparation before non-cardiac surgery deserves particular attention in patients withcardiac disease as these are prone to develop hemodynamic instability and myocardial ischemia. Riskof complications is not only related to individual patient characteristics, but also to surgery relatedfactors. In this report we present our experience regarding anesthetic management of a patient withmultiple comorbidities including advanced chronic obstructive pulmonary disease, severely impaired leftventricular systolic function and occluded bypass grafts. We chose thoracic epidural analgesia for his subxiphoidincisional hernia repair. The operative and postoperative course was uneventful.