Morita Y, Sanuki M, Kinoshita H
Department of Anesthesia and Intensive Care, Hiroshima City Asa Hospital, Hiroshima 731-0293.
Masui. 2001 Dec;50(12):1348-50.
A 70-year-old man, without history of angina pectoris, was scheduled for aorto-femoral bypass graft surgery under epidural anesthesia supplemented with nitrous oxide and sevoflurane. At the beginning of operation, twenty minutes after the start of low flow anesthesia (2 l.min-1), ECG showed an elevation of the ST segment during hypotension. Rising blood pressure and bolus injection of nitroglycerin relieved the elevation and his circulation became stable. It was suspected that a coronary spasm attack was induced by hypotension, as well as vagal stimulation from an inadequate amount of anesthesia. For prevention of intraoperative coronary spasm, it is important to maintain anesthesia at sufficient levels using monitors.
一名70岁男性，无心绞痛病史，计划在硬膜外麻醉复合氧化亚氮和七氟醚下行主动脉-股动脉搭桥手术。手术开始时，低流量麻醉（2升/分钟）开始20分钟后，心电图显示低血压期间ST段抬高。血压升高及静脉推注硝酸甘油后抬高缓解，循环趋于稳定。怀疑低血压以及麻醉深度不足引起的迷走神经刺激诱发了冠状动脉痉挛发作。为预防术中冠状动脉痉挛，使用监测仪将麻醉维持在足够水平很重要。
