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Войти в исследования Regional anesthesia · 1995
Combined general and epidural anesthesia for a patient with Takayasu's arteritis. Case report.
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Gozal Y, Ginosar Y, Gozal D
Аннотация
BACKGROUND AND OBJECTIVES: The case is presented of a 44-year-old woman with type I Takayasu's arteritis, undergoing total abdominal hysterectomy.
METHODS: Her previous symptoms were related to subclavian and vertebral artery lesions that were treated surgically, and to right carotid stenosis (amaurosis fugax 1-year before the operation) that was not treated. Peripheral pulses were present and blood pressure monitoring was not a problem (invasive intra-arterial pressure monitoring was used). Neurologic monitoring was considered to be mandatory in this case and a computerized electroencephalography monitor was used, both to confirm the adequacy of anesthesia and, more importantly, to monitor unilateral cerebrovascular events.
RESULTS: The patient underwent surgery with combined epidural and general anesthesia, without any complications. The epidural block was used throughout the early postoperative period for analgesia.
CONCLUSIONS: The management of patients with Takayasu's arteritis requires a knowledge of the location and pathophysiology of vascular lesions.
METHODS: Her previous symptoms were related to subclavian and vertebral artery lesions that were treated surgically, and to right carotid stenosis (amaurosis fugax 1-year before the operation) that was not treated. Peripheral pulses were present and blood pressure monitoring was not a problem (invasive intra-arterial pressure monitoring was used). Neurologic monitoring was considered to be mandatory in this case and a computerized electroencephalography monitor was used, both to confirm the adequacy of anesthesia and, more importantly, to monitor unilateral cerebrovascular events.
RESULTS: The patient underwent surgery with combined epidural and general anesthesia, without any complications. The epidural block was used throughout the early postoperative period for analgesia.
CONCLUSIONS: The management of patients with Takayasu's arteritis requires a knowledge of the location and pathophysiology of vascular lesions.