Ozer Ayse B, Erhan Omer L, Sumer Cevdet, Yildizhan Ozden
Anaesthesiology and Reanimation Department, Faculty of Medicine, Firat University, 23119 Elazig, Turkey.
Case Rep Anesthesiol. 2012;2012:109346. doi: 10.1155/2012/109346. Epub 2012 Apr 5.
The aim of the present paper is to report the anesthesia administration to a patient who was planned to undergo Heller myotomy for achalasia. There wasnot property in the patient whom allgrove syndrome was excepted any steroid treatment in preoperative period. The night before the operation 18 mg of prednisolone was administered intravenously. Induction of anesthesia was performed with thiopental sodium, vecuronium and fentanyl and the patient received endotracheal intubation. Eyes were taped closed and protected with ointment during surgery. Maintenance of anesthesia was achieved with 2% sevoflurane concentration in 50% O(2)-50% N(2)O. 25 mg of prednisolone was infused preoperatively, and intervention with insulin treatment was initiated when blood glucose level rose to 18 mmol/L at 2 hours. Safe anesthesia can be achieved by observing the preoperative development of tracheal aspiration, adrenal insufficiency and, autonomic dysfunction carefully and maintaining eye protection.
本文旨在报告对一名计划接受贲门失弛缓症Heller肌切开术患者的麻醉管理情况。该患者不存在Allgrove综合征,术前未接受任何类固醇治疗。手术前一晚静脉注射18毫克泼尼松龙。采用硫喷妥钠、维库溴铵和芬太尼进行麻醉诱导,患者接受气管插管。手术期间眼睛用胶布闭合并用眼膏保护。通过在50%氧气-50%氧化亚氮中使用2%的七氟醚浓度维持麻醉。术前输注25毫克泼尼松龙,当2小时血糖水平升至18毫摩尔/升时开始胰岛素治疗干预。通过仔细观察术前气管误吸、肾上腺功能不全和自主神经功能障碍的发展情况并维持眼部保护,可实现安全麻醉。