胸前大动脉内血管修复的麻醉考虑因素
Olivia M Valencia1, Thomas Powell1, Ali Khalifa1
1Division of Cardiovascular Anesthesiology, Texas Heart Institute, Baylor College of Medicine, Houston, TX, USA.
Seminars in cardiothoracic and vascular anesthesia
|November 1, 2024
概括
胸前大动脉病理的内血管修复为开放性手术提供了替代方案. 麻醉科医生面临着管理那些接受这些先进的大动脉修复手术的患者的新挑战.
科学领域:
- 心血管外科心血管外科
- 麻醉学 麻醉学
- 血管医学 血管医学
背景情况:
- 胸前大动脉病理的传统开放性手术修复具有重大风险,包括缺血性末端器官损伤.
- 对上升大动脉和大动脉病理的内血管修复技术正在发展,呈现出新的临床情景.
研究的目的:
- 审查胸前大动脉病理的内血管修复麻醉方面的考虑.
- 为麻醉科医生管理这些复杂的病例提供全面的概述.
主要方法:
- 关于血管内胸前动脉修复的当前文献的综述.
- 讨论麻醉相关的病理生理学,手术技术和患者管理.
主要成果:
- 血管内修复越来越成功,但它带来了独特的麻醉挑战.
- 综合性的术前,术后和术后管理策略至关重要.
结论:
- 麻醉科医生需要专门的知识来管理接受血管内胸前动脉修复的患者.
- 本综述强调了优化患者在这个不断增长的领域的结果的关键方面.
相关概念视频
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
367
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...
367
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
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


