Matsumoto Yu, Shibuta Satoshi, Morita Tomotaka, Iritakenishi Takeshi, Nishimura Nobuyuki, Koide Moe, Fujino Yuji
Department of Anesthesiology and Intensive Care Medicine, Graduate School of Medicine D7, Osaka University, 2-2, Yamadaoka, Suita, 565-0871 Japan.
JA Clin Rep. 2015;1(1):21. doi: 10.1186/s40981-015-0013-6. Epub 2015 Sep 2.
Non-cardiac surgery should only be performed in patients with Eisenmenger's syndrome if absolutely mandatory because these patients are at high risk of perioperative mortality. Proper anesthetic and perioperative pain management in these patients remains a controversial topic. Transversus abdominis plane (TAP) block provides safe and beneficial perioperative analgesia in adults and children; however, no report has described the performance of TAP block in a child with Eisenmenger's syndrome. Herein, we describe the performance of bilateral orchiopexy for cryptorchidism in an 8-year-old boy with Eisenmenger's syndrome due to an uncorrected muscular ventricular septal defect (mVSD). Anesthesia induction and maintenance were uneventful. Subsequently, the patient received ultrasound-guided bilateral TAP block by using 10 mL of 0.25 % levobupivacaine shortly before recovery from anesthesia. The TAP block provided pain relief and maintenance of stable hemodynamics during the postoperative period. We successfully used a TAP block in a child with Eisenmenger's syndrome to provide postoperative analgesia. No side effects were apparent during the perioperative period. TAP block can be considered a beneficial pain management technique for analgesia in children with Eisenmenger's syndrome.
仅在绝对必要时，才应对患有艾森曼格综合征的患者进行非心脏手术，因为这些患者围手术期死亡风险很高。这些患者适当的麻醉和围手术期疼痛管理仍是一个有争议的话题。腹横肌平面（TAP）阻滞可为成人和儿童提供安全有益的围手术期镇痛；然而，尚无关于在患有艾森曼格综合征的儿童中实施TAP阻滞的报道。在此，我们描述了一名8岁患有艾森曼格综合征的男孩因未矫正的肌部室间隔缺损（mVSD）行双侧隐睾固定术的情况。麻醉诱导和维持过程顺利。随后，患者在麻醉恢复前不久接受了超声引导下双侧TAP阻滞，使用10毫升0.25%左旋布比卡因。TAP阻滞在术后提供了疼痛缓解并维持了血流动力学稳定。我们成功地在一名患有艾森曼格综合征的儿童中使用TAP阻滞提供术后镇痛。围手术期未出现明显副作用。TAP阻滞可被认为是一种对患有艾森曼格综合征儿童有益的镇痛管理技术。
