Guimarães Jordana de Fraga, Angonese Cristine Formighieri, Gomes Rafael Klein, Junior Vasco Miranda, Farias Carlos
Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil.
Complexo Hospitalar da Santa Casa de Misericórdia de Porto Alegre, Serviço de Anestesiologia, Porto Alegre, RS, Brasil; Hospital Sírio Libanês, São Paulo, SP, Brasil.
Rev Bras Anestesiol. 2017 Nov-Dec;67(6):626-631. doi: 10.1016/j.bjan.2015.12.003. Epub 2016 Jan 23.
Vascular bypass is a surgical procedure widely used to treat peripheral vascular disease. The intraoperative anesthetic technique and the most appropriate postoperative analgesia for these high-risk patients remain controversial. We present the case of a patient undergoing femoropopliteal-distal bypass in our service, presenting with relevant comorbidities to the choice of anesthetic technique. This patient had several determining factors of difficult airway, especially thoracic kyphoscoliosis, which prevented him from being properly positioned for airway management, and chronic lung disease. This patient was also taken antiplatelet drugs, which is a contraindication for neuraxial block. So, we chose the anesthetic technique of peripheral nerve block, specifically the blockade of femoral and sciatic nerves.
血管搭桥术是一种广泛用于治疗周围血管疾病的外科手术。对于这些高危患者，术中麻醉技术和最合适的术后镇痛方法仍存在争议。我们介绍了一例在我院接受股腘-远端搭桥术的患者，该患者的合并症对麻醉技术的选择具有重要影响。该患者有多个导致气道困难的决定因素，尤其是胸椎后凸侧弯，这使得他无法为气道管理进行正确体位摆放，此外还有慢性肺部疾病。该患者还服用抗血小板药物，这是神经轴阻滞的禁忌证。因此，我们选择了外周神经阻滞的麻醉技术，具体是股神经和坐骨神经阻滞。
