连续硬膜外阻滞和平衡全麻在综合医院腹主动脉瘤手术中的应用。病例报告

Rafael Cdg, Yamel Ff, Hector Br, Luis Ncj, Nicolas Hdj, Roberto Msj, Andres Efc, Teresa Vgt, Andrea Vv, Alberto Gam, Daniela Clb, Belen Rla, Oscar Qbm, Israel Pme, Manuel Asj, F. Mrm
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引用次数: 0

摘要

腹主动脉瘤(AAA)在我们的人群中变得越来越常见;这种病理的外科治疗是一项高度复杂的手术,必须在设备齐全的医疗单位进行,有工具和合适的人员,因为发病率和死亡率在很大程度上取决于对这些冠状动脉高危患者的术前评估。外周局部区域麻醉技术在麻醉治疗和术后复苏中占有重要地位,因其易发生心血管、呼吸、肾脏并发症或肠系膜缺血,手术风险高,因此,术后管理一般应在重症监护病房进行。目的:介绍在某二级医院采用混合麻醉紧急手术治疗急腹症腹主动脉瘤(AAA)的病例。病例:80岁高龄患者,诊断为肾下AAA,因腹痛行急诊手术,全麻平衡加硬膜外阻滞,植入分岔涤纶合成移植物,因重症监护室(ICU)无房,术后处理在普外科住院区,进展正常。结论:进化在很大程度上取决于麻醉技术,麻醉技术必须朝着多模式策略发展,血流动力学稳定性是优先考虑的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Continuous Epidural Block and Balanced General Anesthesia in Abdominal Aortic Aneurysm Surgery in a General Hospital. Case Report
Introduction: Abdominal Aortic Aneurysms (AAA) are becoming more frequent in our population; the surgical management of this pathology represents a highly complex surgery which must be performed in a well-equipped medical unit, with implements and suitable personnel, since morbidity and mortality depends a lot on the preoperative evaluation of these patients with high coronary risk. Peripheral locoregional anesthesia techniques occupy an important place in anesthetic treatment and postoperative resuscitation due to the frequent possibility of cardiovascular, respiratory, renal complications or mesenteric ischemia, which justifies a treatment adapted to the high surgical risk, therefore, postoperative management should generally be in an Intensive Care Unit. Objective: Present the case of a patient with Abdominal Aortic Aneurysm (AAA) with acute abdomen urgently operated in a second-level hospital using mixed anesthesia. Case: Octogenarian patient with a diagnosis of infrarenal AAA, undergoing emergency surgery for abdominal pain, which was under balanced general anesthesia plus epidural block a bifurcated Dacron synthetic graft was interposed, with postoperative management in general surgery hospitalization area because there was no availability in the Intensive Care Unit (ICU), evolving properly. Conclusion: Evolution depends a lot on the anesthetic technique, which must be directed towards a multimodal strategy, where hemodynamic stability is a priority.
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