结合TAVR和大动脉内血管手术中的麻醉考虑,一个案例报告
Mario Zaccarelli1, Tarek S Testa2, Giuseppe Buscaglia2
1Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genova, Italy.
Annals of cardiac anaesthesia
|April 12, 2024
概括
本案例研究突出说明了用于同时进行跨导管大动脉置换和内血管动脉瘤修复的局部和区域麻醉. 这些麻醉方法对于在复杂的内血管程序中保持血液动力稳定至关重要.
科学领域:
- 心血管外科心血管外科
- 麻醉学 麻醉学
- 干预心脏病学 干预心脏病学
背景情况:
- 综合透气管大动脉置换 (TAVR) 和内血管动脉瘤修复 (EVAR) 是复杂的程序.
- 这些联合干预措施带来了重大的血液动力学挑战.
- 麻醉的选择极大地影响了患者在此类手术中的稳定性.
相关概念视频
General Anesthesia: Overview
215
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...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
215
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
408
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
408
Parenteral Anesthetics: Overview
119
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.
119
Endotracheal Intubation II: Nursing Management
597
Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
597
Local Anesthetics: Clinical Application as Spinal Anesthesia
623
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...
623
Inhalational Anesthetics: Overview
274
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
274


