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Related Concept Videos

General Anesthesia: Overview01:24

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...

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Anesthesia for pulmonary endarterectomy.

Gerard R Manecke1

  • 1Department of Anesthesiology, University of California San Diego, USA. gmanecke@UCSD.edu

Seminars in Thoracic and Cardiovascular Surgery
|December 23, 2006
PubMed
Summary

Anesthetic management for pulmonary endarterectomy is complex due to chronic thromboembolic pulmonary hypertension and right ventricular failure. This review covers challenges and strategies for anesthetic care during and after cardiopulmonary bypass.

Area of Science:

  • Cardiac Anesthesia
  • Pulmonary Hypertension Management
  • Surgical Patient Care

Background:

  • Pulmonary endarterectomy is a high-risk procedure for cardiac anesthesia.
  • Chronic thromboembolic pulmonary hypertension (CTEPH) causes right ventricular failure and hemodynamic instability.
  • Patient comorbidities, including pulmonary and hepatic issues, impact anesthetic drug efficacy.

Purpose of the Study:

  • To review the anesthetic challenges associated with pulmonary endarterectomy.
  • To provide management strategies for perioperative complications.
  • To optimize patient outcomes during this complex cardiac surgery.

Main Methods:

  • Review of current anesthetic practices for pulmonary endarterectomy.
  • Analysis of hemodynamic management during cardiopulmonary bypass (CPB).

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Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow

Published on: January 13, 2017

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Last Updated: Jul 18, 2026

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  • Discussion of strategies for managing post-CPB complications.

    • Main Results:

    • Anesthetic induction and CPB require careful hemodynamic monitoring.
    • Maintaining cerebral oxygenation and adequate hypothermia is crucial during CPB.
    • Post-CPB care involves managing residual pulmonary hypertension, edema, bleeding, and right ventricular failure.

    Conclusions:

    • Anesthesiologists face significant challenges in managing patients undergoing pulmonary endarterectomy.
    • Proactive management of hemodynamic instability and comorbidities is essential.
    • Effective strategies can mitigate risks associated with CPB and circulatory arrest.