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一例预激综合征患者的麻醉管理

Anaesthetic management of a case of Wolff-Parkinson-White syndrome.

作者信息

Kabade Savitri D, Sheikh Safiya, Periyadka Bhavya

机构信息

Department of Anesthesia, KIMS Hubli, Karnataka, India.

出版信息

Indian J Anaesth. 2011 Jul;55(4):381-3. doi: 10.4103/0019-5049.84868.

Abstract

We report a case of fibroid uterus with Wolff-Parkinson-White (WPW) syndrome in a 48-year-old female, posted for elective hysterectomy. Patient gave history of short recurrent episodes of palpitation and electrocardiograph confirmed the diagnosis of WPW syndrome. The anaesthetic management of these patients is challenging as they are known to develop life threatening tachyarrhythmia like paroxysmal supra-ventricular tachycardia (PSVT) and atrial fibrillation (AF). Epidural anaesthesia is preferred compared to general anaesthesia to avoid polypharmacy, noxious stimuli of laryngoscopy and intubation. To deal with perioperative complications like PSVT and AF, anti-arrhythmic drugs like adenosine, beta blockers and defibrillator should be kept ready. Perioperative monitoring is essential as patients can develop complications.

摘要

我们报告一例48岁患有子宫平滑肌瘤合并预激综合征(WPW)的女性患者,计划行择期子宫切除术。患者有反复发作的心悸病史,心电图确诊为WPW综合征。这类患者的麻醉管理具有挑战性,因为他们已知会发生危及生命的快速性心律失常,如阵发性室上性心动过速(PSVT)和心房颤动(AF)。与全身麻醉相比,硬膜外麻醉更受青睐,以避免联合用药、喉镜检查和插管的有害刺激。为应对围手术期并发症,如PSVT和AF,应准备好腺苷、β受体阻滞剂和除颤器等抗心律失常药物。围手术期监测至关重要,因为患者可能会出现并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d75/3190514/2d1e6b7320a2/IJA-55-381-g001.jpg

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