Use of NIV in Surgery Procedures in Elderly (Noninvasive Surgery): Continuous Spinal Anesthesia

  • Zehra Hatipoglu
  • Dilek Ozcengiz


The anesthetic management of elderly patients with coexisting diseases is important when considering the mortality and morbidity rates. In order to avoid tracheal intubation and the use of neuromuscular and other anesthetic agents, regional techniques are preferred for these patients. Furthermore, during regional anesthesia, respiratory support via noninvasive ventilation may allow patients to undergo more comfortable and safe operations.



Auto-titrating continuous positive airway pressure


American Society of Anesthesiologists


Adaptive servo-ventilation


Bi-level positive airway pressure


Body mass index


Chronic obstructive pulmonary disease


Continuous positive airway pressure


Expiratory positive airway pressure


Inspiratory positive airway pressure


Noninvasive ventilation


Obstructive sleep apnea


Peripheral oxygen saturation


  1. 1.
    Lutz W, Sanderson W, Scherbov S. The coming acceleration of global population ageing. Nature. 2008;451(7179):716–9.CrossRefGoogle Scholar
  2. 2.
    Qaseem A, Snow V, Fitterman N, et al. Clinical Efficacy Assessment Subcommittee of the American College of Physicians. Risk assessment for and strategies to reduce perioperative pulmonary complications for patients undergoing noncardiothoracic surgery: a guideline from the American College of Physicians. Ann Intern Med. 2006;144(8):575–80.CrossRefGoogle Scholar
  3. 3.
    Goncalves GA, Prezzi ED, Carletti GM, et al. Use of noninvasive positive pressure ventilation and spinal anesthesia during hip replacement arthroplasty in a patient with severe chronic obstructive pulmonary disease: case report. Rev Bras Ter Intensiva. 2008;20(3):313–7.CrossRefGoogle Scholar
  4. 4.
    Hillman DR, Jungquist CR, Auckley D. Perioperative implementation of noninvasive positive airway pressure therapies. Respir Care. 2018;63(4):479–87.CrossRefGoogle Scholar
  5. 5.
    Cabrini L, Nobile L, Plumari VP, et al. Intraoperative prophylactic and therapeutic non-invasive ventilation: a systematic review. Br J Anaesth. 2014;112(4):638–47.CrossRefGoogle Scholar
  6. 6.
    Cullen A, Ferguson A. Perioperative management of the severely obese patient: a selective pathophysiological review. Can J Anaesth. 2012;59(10):974–96.CrossRefGoogle Scholar
  7. 7.
    Leech CJ, Baba R, Dhar M. Spinal anaesthesia and non-invasive positive pressure ventilation for hip surgery in an obese patient with advanced chronic obstructive pulmonary disease. Br J Anaesth. 2007;98(6):763–5.CrossRefGoogle Scholar
  8. 8.
    Alonso-Inigo JM, Herranz-Gordo A, Fas MJ, et al. Epidural anesthesia and non-invasive ventilation for radical retropubic prostatectomy in two obese patients with chronic obstructive pulmonary disease. Rev Esp Anestesiol Reanim. 2012;59(10):573–6.CrossRefGoogle Scholar
  9. 9.
    von Ungern-Sternberg BS, Regli A, Schneider MC, et al. Effect of obesity and site of surgery on perioperative lung volumes. Br J Anaesth. 2004;92(2):202–7.CrossRefGoogle Scholar
  10. 10.
    Numata T, Nakayama K, Fujii S, et al. Risk factors of postoperative pulmonary complications in patients with asthma and COPD. BMC Pulm Med. 2018;18(1):4.CrossRefGoogle Scholar
  11. 11.
    Thys F, Delvau N, Roeseler J, et al. Emergency orthopaedic surgery under noninvasive ventilation after refusal for general anaesthesia. Eur J Emerg Med. 2007;14(1):39–40.CrossRefGoogle Scholar
  12. 12.
    Bapat PP, Anderson JA, Bapat S, et al. Use of continuous positive airway pressure during spinal anaesthesia in a patient with severe chronic obstructive pulmonary disease. Anaesthesia. 2006;61(10):1001–3.CrossRefGoogle Scholar
  13. 13.
    Marinho A, Guimaraes MJ, Lages NC, et al. Role of noninvasive ventilation in perioperative patients with neuromuscular disease: a clinical case. Braz J Anesthesiol. 2016;66(1):72–4.CrossRefGoogle Scholar
  14. 14.
    Dawson J, Jones M, Hirschauer N, et al. Continuous spinal anaesthesia and non-invasive ventilation for total knee replacement in a patient on home ventilation. Br J Anaesth. 2012;109(1):125–6.CrossRefGoogle Scholar
  15. 15.
    Kato T, Suda S, Kasai T. Positive airway pressure therapy for heart failure. World J Cardiol. 2014;6(11):1175–91.CrossRefGoogle Scholar
  16. 16.
    Iwama H. Application of nasal bi-level positive airway pressure to respiratory support during combined epidural-propofol anesthesia. J Clin Anesth. 2002;14(1):24–33.CrossRefGoogle Scholar
  17. 17.
    Ohmizo H, Morota T, Seki Y, et al. Combined spinal-propofol anesthesia with noninvasive positive-pressure ventilation. J Anesth. 2005;19(4):311–4.CrossRefGoogle Scholar
  18. 18.
    Kinoshita H, Matsuda N, Hatano Y. The use of capnography for apnea monitoring during non-invasive positive pressure ventilation during spinal anesthesia. Can J Anaesth. 2007;54(10):850.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Zehra Hatipoglu
    • 1
  • Dilek Ozcengiz
    • 1
  1. 1.Department of Anesthesiology, Faculty of MedicineCukurova UniversityAdanaTurkey

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