St Lukes/Roosevelt Hospital Center, Columbia University, College of Physicians and Surgeons, New York City, New York 10025, USA.
Prog Cardiovasc Dis. 2012 May-Jun;54(6):503-11. doi: 10.1016/j.pcad.2012.04.002.
Hypertrophic obstructive cardiomyopathy presents a challenge to the anesthesiologist. Because the condition is relatively prevalent, it is important for anesthesiologist to be aware of the pathophysiology. In this review, we draw upon case reports and studies of the anesthesia management of patients with hypertrophic obstructive cardiomyopathy to enhance medical decision making. The scope of this article ranges from the preoperative period, when the severity of the obstruction needs to be assessed; the intraoperative period, with monitoring, as well as general management guidelines; and finally, the postoperative period, when it is important to minimize the sympathetic response. Furthermore, we address the management of the obstetric patient, with particular focus on neuraxial anesthesia, and extrapolate how this type of anesthesia may be applied to the management of patients undergoing nonlaboring, noncardiac surgery.
肥厚型梗阻性心肌病给麻醉师带来了挑战。由于这种疾病比较普遍，麻醉师了解其病理生理学知识非常重要。在这篇综述中，我们借鉴了肥厚型梗阻性心肌病患者的麻醉管理案例报告和研究，以增强医疗决策。本文的范围从术前阶段，需要评估梗阻的严重程度；到术中阶段，包括监测和一般管理指南；最后是术后阶段，重要的是要最大限度地减少交感神经反应。此外，我们还讨论了产科患者的管理，特别关注脊麻，并推断这种类型的麻醉如何应用于非分娩、非心脏手术患者的管理。
