Takahata O, Yurino M, Ogawa H, Ishimura N, Kumano H, Nishiwada M
Department of Anesthesiology, Asahikawa Medical College.
Masui. 1990 Aug;39(8):1040-4.
We experienced 5 cases of intraoperative anoxic spell in 48 patients with tetralogy of Fallot (TOF). One of 5 cases had tetralogy with pulmonary atresia (Type A), and the others had tetralogy alone (Type D). The patient of type A who had anoxic spells during preoperative period had been on chronic propranolol therapy. However, the patients of type D had no anoxic spells during preoperative period and one in this type had not been on beta-adrenergic blocking drugs preoperatively. One patient was anesthetized with fentanyl-diazepam-O2, and the others were anesthetized with morphine-diazepam-O2. We used mainly alpha-adrenergic drugs and sodium bicarbonate for the therapy of intraoperative anoxic spells. Concerning the intraoperative anoxic spell, we have to be aware in the management of the patients with TOF, whether the patient had anoxic spells during preoperative period or not.
在48例法洛四联症（TOF）患者中，我们遇到了5例术中缺氧发作的情况。5例中有1例为伴有肺动脉闭锁的四联症（A型），其余为单纯四联症（D型）。术前有缺氧发作的A型患者一直在接受慢性普萘洛尔治疗。然而，D型患者术前没有缺氧发作，且该型中有1例术前未使用β-肾上腺素能阻滞剂。1例患者用芬太尼-地西泮-O₂麻醉，其余患者用吗啡-地西泮-O₂麻醉。我们主要使用α-肾上腺素能药物和碳酸氢钠治疗术中缺氧发作。关于术中缺氧发作，在法洛四联症患者的管理中，我们必须注意患者术前是否有缺氧发作。
