다가야스 동맥염 ( Takayasu's Arteritis ) 환자의 술중 및 술후 혈역학적 감시

Abstract

Takayasu's arteritis is a chronic, idiopathic occlusive inflammation of the aorta, its major branches, and/or the pulmonary artery, We present anesthetic management and monitoring techniques of the patient with Takayasu arteritis who had a transabdominal hysterectomy under, general anesthesia. She had previously taken coronary artery bypass graft due to left main coronary and left pulmonary artery stenosis. Angiography showed narrowing of the aortic arch with complete obstruction of both subclavian arteries and grafted left circumflex artery, partial obstruction of left main coronary artery, With KKG monitoring, a Swan-Ganz catheter was inserted without incident before anesthetic induction. Perioperative blood pressure was obtained using a sphygmomacnometer cuff over the left upper arm and through femoral arterial catheter. The anesthesia was induced as a usual manner. We attp to avoid myocardial depression and promote cerebral vasodilation during the maintenence of anesthesia by combining O2-fentanyl-vecuronium, low concentrations of isoflurane, and normocarbia. The intraoperative period was unevenful except for a brief period of slightly decreased blood pressure just after intubation. Perioperative hemo- dynamic stats were stable and cardiac output was within normal limits.