在上腺切除术期间治疗耐火性低血压的管理在用氧胺治疗的狗中
Marcela L Machado1, Bruno H Pypendop1, Joao Hn Soares1
1Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA.
Veterinary anaesthesia and analgesia
|April 6, 2025
概括
这项案例研究强调了管理患有恶性上腺瘤的狗的挑战. 术前对高血压的α-1上腺激素抗剂治疗导致手术内低血压和低氧化,导致安乐死.
科学领域:
- 兽医医学 兽医医学 兽医医学
- 手术瘤学手术瘤学
- 麻醉学 麻醉学
背景情况:
- 染细胞瘤是一种分泌甲醇胺的上腺瘤,可以导致严重的高血压.
- 恶性上腺瘤带来了重大的手术和麻醉风险.
- 手术前的管理旨在减轻与多余的甲基荷兰胺相关的风险.
研究的目的:
- 描述患有恶性上腺瘤的狗的麻醉和手术管理.
- 报告使用不可逆转的α-1上腺激素抗剂治疗手术前高血压.
- 为了记录手术期间遇到的血液动力学和呼吸系统挑战.
主要方法:
- 一名患有恶性上腺体质量的12岁的石接受了上腺切除术.
- 术前治疗包括氧胺,一种不可逆转的α-1上腺激素抗剂.
- 麻醉包括甲,阿特罗平,阿尔法萨隆,米达佐拉姆和异氨酸.
- 使用了侵入性血压监测和积极的液体和血管压缩器支持.
主要成果:
- 严重的手术前高血压最初是用氧胺治疗的.
- 在手术期间的动脉低血压持续了195分钟,需要多巴胺和乙烯.
- 尽管补充氧气,但发生了手术内和康复性低氧症.
- 由于并发症,这只狗被安乐死.
结论:
- 不可逆转的α-1上腺激素抗剂可能会使患有染细胞瘤的狗的手术内血压管理复杂化.
- 恶性上腺瘤具有复杂的麻醉挑战,需要仔细监测和干预.
- 在这些情况下,低血管理可能很困难.
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