Andrews J D
Fairview Park Hospital, Dublin, Georgia, USA.
AANA J. 1999 Feb;67(1):67-71.
A 24-year-old woman with a history of unrepaired tetralogy of Fallot was scheduled to undergo laparoscopic cholecystectomy. Her significant history included tetralogy of Fallot with pulmonary atresia, hypoplastic left pulmonary artery, pulmonary vascular obstructive disease, a functioning right subclavian artery to right pulmonary artery shunt (modified Blalock-Taussig palliative procedure) with a similar shunt on the left side that is occluded. The patient underwent general endotracheal anesthesia for laparoscopic cholecystectomy for cholelithiasis and pancreatitis. Anesthetic induction, intraoperative course, and the postoperative period proceeded uneventfully, and the patient quickly progressed to the preoperative level of functioning. The careful application of pharmacological and physiological principles guided the anesthetic plan and produced a successful outcome. Principles for the anesthetic management of the patient with cyanotic congenital heart disease undergoing noncardiac surgery are reviewed.
一名患有法洛四联症且未接受修复手术的24岁女性计划接受腹腔镜胆囊切除术。她的重要病史包括法洛四联症合并肺动脉闭锁、左肺动脉发育不全、肺血管阻塞性疾病、右锁骨下动脉至右肺动脉分流（改良布莱洛克-陶西格姑息手术）功能正常，左侧有类似分流但已闭塞。该患者因胆结石和胰腺炎接受腹腔镜胆囊切除术，采用全身气管内麻醉。麻醉诱导、术中过程及术后恢复均顺利，患者很快恢复到术前功能水平。药理学和生理学原理的谨慎应用指导了麻醉方案并取得了成功结果。本文综述了患有青紫型先天性心脏病的患者接受非心脏手术时的麻醉管理原则。
