Title: ANAESTHESTIC MANAGEMENT OF ELDERLY PATIENT WITH CORONARY HEART DISEASE AND COPD POSTED FOR SHOULDER DISARTICULATION SUFFERING FROM METASTATIC SQUAMOUS CELL CARCINOMA IN UPPER 1/3 OF HUMERUS UNDER COMBINED CERVICAL AND INTERSCALENE BLOCK
Abstract: We present a case of elderly patient aged 60 years posted for left shoulder disarticulation who is suffering from metastatic squamous cell carcinoma in upper 1/3 of left humerus with coronary heart disease and COPD as comorbid factors.Coronary heart disease and COPD are the two most common and dangerous risk factors contributing to high morbidity and mortality during surgery.General Anaesthesia in patients with coronary heart disease and COPD results in high mortality during surgery.Perioperative optimization of these high-risk patients deserves a thorough understanding of the patient cardiopulmonary diseases as well as the respiratory consequences of surgery and anesthesia.In order to avoid high morbidity and mortality associated with General Anaesthesia in patients with coronary heart disease and COPD, we opted for shoulder disarticulation surgery under continuous combined cervical and interscalene block.This case highlights the advantage of the regional nerve blocks over General Anaesthesia in patients with coronary heart disease and COPD.