Perioperative Anaesthetic Management in a Patient with IHD And Drug Eluting Stent Undergoing Tibia Plating

Dr. Bhagyashri, Dr. Harshith S, Dr. Sidramayya, Dr. Parimala

Abstract: This case report describes the perioperative management of a 47 - year - old male patient with ischemic heart disease (IHD) and a drug - eluting stent (DES) who underwent tibial plating. The complexity of this case lies in the need to balance the risks of stent thrombosis and myocardial infarction (MI) due to the recent placement of the DES, against the risk of bleeding associated with the use of dual antiplatelet therapy (DAPT). Bridging therapy with enoxaparin was administered to mitigate the thrombotic risk, while a combined epidural and spinal anaesthetic technique was employed to ensure adequate pain control and hemodynamic stability. The case underscores the importance of a multidisciplinary approach, meticulous anaesthetic planning, and careful postoperative management to improve patient outcomes in the perioperative setting for individuals with a recent DES - PCI.

Keywords: Ischaemic heart disease, Drug eluting stent, Dual antiplatelet therapy, perioperative management, regional anaesthesia