Regional Versus General Anesthesia in Severe Aortic Stenosis: Revisiting Hemodynamic Assumptions
DOI:
https://doi.org/10.65495/eurjimr.2026.17Keywords:
aortic stenosis, general anesthesia, regional anesthesiaAbstract
Severe aortic stenosis (AS) presents significant perioperative challenges due to fixed left ventricular outflow obstruction, impaired diastolic function, and dependence on adequate preload and systemic vascular resistance. Traditional anesthetic practice has favored general anesthesia (GA) over regional anesthesia (RA) because of concerns regarding sympathetic blockade and hemodynamic instability. However, emerging evidence suggests that carefully titrated regional techniques, particularly peripheral nerve blocks, may preserve cardiovascular stability by avoiding rapid vasodilation and tachycardia associated with induction and intubation. This article revisits the physiologic basis of anesthetic management in severe AS and argues against a binary approach to technique selection. Instead, it emphasizes individualized, physiology-driven strategies tailored to procedural type and patient condition, highlighting the need for prospective studies to refine evidence-based recommendations.
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No new data were generated or analyzed in this study. Data sharing is not applicable to this article.
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Copyright (c) 2026 Emine Özdemir, Ali Can Özdemir (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
