Yamane Yui, Omae Takeshi, Kou Keito, Sakuraba Sonoko
Department of Anesthesiology and Pain Clinic, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka 1129 Japan.
JA Clin Rep. 2017;3(1):53. doi: 10.1186/s40981-017-0126-1. Epub 2017 Oct 3.
We described a case in which femoral nerve block (FNB) and lateral femoral cutaneous nerve block (LFCNB) with dexmedetomidine (DEX) was useful for open reduction and internal fixation (ORIF) of a femoral neck fracture in a patient with severe aortic stenosis. Cardiac surgery had been recommended but was declined by the patient. Thus, ORIF was selected because of the patient's concomitant severe aortic stenosis. The anesthesia method used was FNB plus LFCNB with DEX, which achieved adequate local anesthesia. DEX was used to avoid respiratory depression because this patient has pulmonary hypertension. This patient had been sedative up to the end of surgery. Total operating time was 51 min, and the patient's hemodynamics were stable throughout the perioperative period. There were no complications. In this case, anesthesia using a nerve block with DEX contributed to the safety of noncardiac surgery in a patient with severe cardiac disease under conservative treatment during the perioperative period.
我们描述了一例在患有严重主动脉瓣狭窄的患者中，使用右美托咪定（DEX）进行股神经阻滞（FNB）和股外侧皮神经阻滞（LFCNB）对股骨颈骨折切开复位内固定术（ORIF）有用的病例。曾建议进行心脏手术，但患者拒绝了。因此，由于患者伴有严重主动脉瓣狭窄，选择了ORIF。所采用的麻醉方法是FNB加LFCNB并使用DEX，获得了充分的局部麻醉。使用DEX是为了避免呼吸抑制，因为该患者患有肺动脉高压。该患者在手术结束前一直处于镇静状态。总手术时间为51分钟，患者围手术期的血流动力学稳定。无并发症发生。在此病例中，使用含DEX的神经阻滞进行麻醉有助于围手术期保守治疗的严重心脏病患者非心脏手术的安全性。
