Uzawa Koji, Hakone Masako, Nakazawa Harumasa, Yasuda Hiroyuki, Moriyama Kiyoshi, Yorozu Tomoko
Department of Anesthesiology, Kyorin University, School of Medicine, Mitaka 181 8611.
Masui. 2014 Feb;63(2):157-60.
A 75-year-old woman with primary pulmonary hypertension was on medical therapy and ambulatory oxygen inhalation therapy for 7 years. The patient had right femoral fracture and was admitted to our hospital. She had also suffered from asthma for 2 years, and her vital capacity was 1.35 l with forced expiratory volume in 1 second 0.79 l, and with her mean pulmonary artery pressure 60 mmHg. Open reduction and internal fixation were performed under spinal anesthesia using isobaric bupivacaine 6 mg with fentanyl 10 microg, and the patient was discharged on postoperative 31 day with no major complications. One year after the surgery, she had left femoral fracture, and surgery was performed under spinal anesthesia using isobaric bupivacaine 6 mg with fentanyl 10 microg. With its minimal effects on hemodynamics, we speculate that spinal anesthesia using a low dose of isobaric bupivacaine can be a choice for patients with pulmonary hypertension.
一名75岁的原发性肺动脉高压女性患者接受药物治疗和持续吸氧治疗已7年。该患者发生右股骨骨折，入住我院。她还患有哮喘2年，肺活量为1.35升，第1秒用力呼气量为0.79升，平均肺动脉压为60 mmHg。在蛛网膜下腔麻醉下，使用等比重布比卡因6 mg加芬太尼10 μg进行切开复位内固定手术，患者术后第31天出院，无重大并发症。术后1年，她发生左股骨骨折，在蛛网膜下腔麻醉下，使用等比重布比卡因6 mg加芬太尼10 μg进行手术。鉴于其对血流动力学影响极小，我们推测低剂量等比重布比卡因蛛网膜下腔麻醉可为肺动脉高压患者提供一种选择。
