在局部麻醉下进行的全内镜脊柱外科手术中,心脏骤停是一种不寻常的并发症:一个病例报告
Takahiro Ogawa1,2, Masatoshi Morimoto1, Fumitake Tezuka1
1Department of Orthopedics, Tokushima University, 3-18-15 Kuramoto, Tokushima, Tokushima 770-8503, Japan.
The journal of medical investigation : JMI
|October 27, 2024
概括
像心脏骤停这样的紧急情况可以发生在局部麻醉下的全内镜脊柱外科手术中,即使在老年患者中也是如此. 仔细的手术内监测对于这些手术期间的患者安全至关重要.
科学领域:
- 神经外科 神经外科
- 心脏病学 心脏病学
- 麻醉学 麻醉学
背景情况:
- 整体内镜脊柱外科手术提供了一种比全身麻醉更安全的替代方案,特别是对于老年患者.
- 尽管局部麻醉有好处,但手术期间仍可能出现紧急情况.
- 这一案例突出了脊柱微创手术期间的关键事件.
研究的目的:
- 在局部麻醉下进行全内镜脊柱手术时报告一例罕见的心脏骤停.
- 强调接受此类手术的老年患者的警监测的重要性.
主要方法:
- 一个80岁的女性患者的病例介绍,患有腰椎脊柱狭窄症.
- 在局部麻醉下进行了两阶段的全内镜脊柱手术.
- 由于莫比茨II型心房阻塞导致心脏骤停,需要立即进行皮肤穿和临时心脏起器插入.
主要成果:
- 心脏骤停发生在第二阶段的计划手术.
- 患者需要紧急节拍和随后的永久心脏起器植入.
- 在稳定后,第二阶段的减压成功完成.
结论:
- 在局部麻醉下接受手术的老年患者需要与在全身麻醉下接受手术的患者相同的强化手术内监测水平.
- 及时识别和管理心脏事件对于患者的治疗结果至关重要.
- 这一案例强调了在内镜脊柱手术中为麻醉并发症做好准备的必要性.
相关概念视频
Local Anesthetics: Clinical Application as Spinal Anesthesia
585
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...
585
Local Anesthetics: Clinical Application as Epidural Anesthesia
414
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
414
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
369
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...
369
General Anesthesia: Overview
196
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...
196
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
53
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...
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...
53
Aneurysm IV: Nursing Management
2
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...
2

