Neuraxial anesthesia for patients with severe pulmonary arterial hypertension undergoing urgent open abdominal surgeries: two case reports.

Pub Date : 2024-09-02 DOI:10.1186/s40981-024-00737-w

Shuhei Yamada, Yoshiaki Takise, Yuri Sekiya, Yuya Masuda, Yoshi Misonoo, Kenta Wakaizumi, Tomohiro Suhara, Hiroshi Morisaki, Jungo Kato, Takashige Yamada

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Abstract

Background: There is no consensus regarding the choice of anesthetic method for patients with pulmonary hypertension (PH). We report two cases in which neuraxial anesthesia was safely performed without general anesthesia during open abdominal surgery in patients with severe PH.

Case presentation: Case 1: A 59-year-old woman had an atrial septal defect and a huge abdominal tumor with a mean pulmonary arterial pressure (PAP) of 39 mmHg and pulmonary vascular resistance (PVR) of 3.5 Wood units. Case 2: A 23-year-old woman who had hereditary pulmonary artery hypertension (mean PAP, 65 mmHg; PVR, 16.45 Wood units). Both patients underwent open abdominal surgery under neuraxial anesthesia without circulatory collapse with intraoperative administration of vasoconstrictors.

Conclusion: Although anesthetic care must be personalized depending on the pathology and severity of PH, neuraxial anesthesia may be an option for patients with severe PH undergoing abdominal surgery.

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为接受紧急开腹手术的严重肺动脉高压患者实施神经麻醉：两份病例报告。

背景：关于肺动脉高压（PH）患者麻醉方法的选择，目前尚未达成共识。我们报告了两例重度肺动脉高压患者在开腹手术中无需全身麻醉即可安全实施神经轴麻醉的病例：病例 1：一名 59 岁女性，患有房间隔缺损和巨大腹部肿瘤，平均肺动脉压（PAP）为 39 mmHg，肺血管阻力（PVR）为 3.5 Wood 单位。病例 2：一名 23 岁女性，患有遗传性肺动脉高压（平均肺动脉压 65 毫米汞柱；肺血管阻力 16.45 伍德单位）。两名患者均在神经轴麻醉下接受了开腹手术，术中使用血管收缩剂后均未出现循环衰竭：结论：虽然麻醉护理必须根据 PH 的病理和严重程度进行个性化设计，但神经轴麻醉可能是接受腹部手术的严重 PH 患者的一种选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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