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麻醉及麻醉医生对支气管热成形术的关注。

Anesthesia and anesthesiologist concerns for bronchial thermoplasty.

作者信息

Agarwal Shilpi, Hoda Wasimul, Mittal Saurbh, Madan Karan, Hadda Vijay, Mohan Anant, Bharti Sachidanand Jee

机构信息

Department of Oncoanaesthesia and Palliative Medicine, Dr. BR Ambedkar IRCH AIIMS, New Delhi, India.

Department of Pulmonary Medicine, AIIMS, New Delhi, India.

出版信息

Saudi J Anaesth. 2019 Jan-Mar;13(1):78-80. doi: 10.4103/sja.SJA_640_18.

Abstract

Bronchial thermoplasty (BT) is an upcoming treatment for patients with asthma refractory to traditional pharmacotherapy. BT is an invasive procedure which carries a risk of coughing, wheezing, bronchospasm, and laryngospasm during and after the procedure. Some of these complications can be minimized using better anesthetic techniques during BT. We hereby report a case of a 63-year-old female with poorly controlled asthma posted for BT done under general anesthesia (GA) with supraglottic device. GA provides better working conditions for pulmonologists when compared with sedation. But still there is no consensus on what would be the ideal anesthetic technique for BT procedure. Till the time, considering anesthesiologist and pulmonologist's prospective, GA (total intravenous anesthesia) using supraglottic device would be a preferred choice for a safe and effective anesthetic strategy in BT.

摘要

支气管热成形术(BT)是一种针对传统药物治疗难治性哮喘患者的新兴治疗方法。BT是一种侵入性手术,在手术期间和术后有咳嗽、喘息、支气管痉挛和喉痉挛的风险。在BT过程中使用更好的麻醉技术可以将其中一些并发症降至最低。我们在此报告一例63岁女性哮喘控制不佳患者,计划在全身麻醉(GA)下使用声门上装置进行BT。与镇静相比,GA为肺科医生提供了更好的工作条件。但对于BT手术的理想麻醉技术仍未达成共识。在此之前,从麻醉医生和肺科医生的角度考虑,使用声门上装置的GA(全静脉麻醉)将是BT安全有效麻醉策略的首选。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73cd/6329243/ab2932220579/SJA-13-78-g001.jpg

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