Rath Amrita, Abhinay J, Loha Sandeep, Singh Atul Kumar
Department of Anesthesiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Anesth Essays Res. 2017 Jan-Mar;11(1):263-265. doi: 10.4103/0259-1162.183160.
Subclavian artery aneurysm is usually operated under general anesthesia (GA), but in specific situations, it can also be conducted under regional anesthesia (RA) such as cervical epidural anesthesia (CEA). A 48-year-old male presented with chief complaint of progressive swelling in the right side of the neck for the past 3 months following trauma. He was diagnosed as subclavian artery aneurysm, and surgical intervention was advised. He had previous history of angina 4 months back for which tablet aspirin 75 mg and tablet clopidogrel 75 mg once daily was prescribed. Cardiological evaluation revealed of an ejection fraction of around 30% with mild left ventricular hypokinesia and grade 2 diastolic dysfunction. Due to the poor cardiac functional status of the patient, RA with CEA was planned. The risk with GA in cases with a history of myocardial ischemia is more than RA, hence, it is better to use CEA which is equally efficacious in such high-risk cases.
锁骨下动脉瘤通常在全身麻醉（GA）下进行手术，但在特定情况下，也可在区域麻醉（RA）下进行，如颈段硬膜外麻醉（CEA）。一名48岁男性，因外伤后右侧颈部进行性肿胀3个月为主诉前来就诊。他被诊断为锁骨下动脉瘤，并建议进行手术干预。他4个月前有过心绞痛病史，当时开具了阿司匹林片75mg和氯吡格雷片75mg，每日一次。心脏评估显示射血分数约为30%，伴有轻度左心室运动功能减退和2级舒张功能障碍。由于患者心脏功能状态较差，计划采用CEA进行区域麻醉。有心肌缺血病史的患者采用GA的风险高于RA，因此，最好使用CEA，其在这类高危病例中同样有效。
