Department of Anesthesia, University of Manitoba, CR3008-369 Tache Avenue, Winnipeg, MB R2H 2A6, Canada.
Can J Anaesth. 2011 Oct;58(10):952-66. doi: 10.1007/s12630-011-9557-8. Epub 2011 Jul 26.
Pericardial diseases present unique perioperative considerations for the anesthesiologist. The purpose of this review is to provide a summary of the pertinent issues related to the etiology, diagnosis, pathophysiology, and perioperative management of patients presenting for operative treatment of pericardial disease.
A selective search of the anesthesia, cardiology, and cardiothoracic surgical literature was carried out with particular emphasis on acute pericarditis, effusion, tamponade, and constrictive pericarditis.
The anesthesiologist needs to be well versed in the etiology (i.e., differential diagnosis), pathophysiology, and diagnostic modalities in order to best prepare the patient for surgery. Diagnosis and guidance of management requires a working knowledge of the specific associated hemodynamic consequences, particularly of the impaired diastolic function that can occur. Echocardiography is essential in the diagnosis and management of these patients.
Patients with acute and chronic pericardial diseases often require the need for surgical intervention. Several unique features of acute tamponade and constrictive pericarditis require careful perioperative consideration. With proper preparation and pre-anesthetic optimization, patients with a variety of pericardial diseases can be safely managed before, during, and after their surgical intervention.
心包疾病对外科麻醉师提出了独特的围手术期考虑因素。本文旨在概述与心包疾病患者手术治疗相关的病因、诊断、病理生理学和围手术期管理的相关问题。
对麻醉学、心脏病学和心胸外科文献进行了选择性检索，特别强调了急性心包炎、心包积液、心包填塞和缩窄性心包炎。
麻醉师需要精通病因学（即鉴别诊断）、病理生理学和诊断方法，以便为手术做好最佳准备。诊断和管理指导需要了解特定的相关血流动力学后果，特别是可能发生的舒张功能障碍。超声心动图在心包疾病患者的诊断和管理中至关重要。
急性和慢性心包疾病患者常需要手术干预。急性填塞和缩窄性心包炎的几个独特特征需要仔细围手术期考虑。通过适当的准备和术前优化，可以安全地管理各种心包疾病患者，包括术前、术中和术后。
