Macharadze Tamar, Davies Andrew, Fedor Igor
Cardiothoracic Critical Care Unit, Wythenshawe Hospital Manchester University, Manchester, United Kingdom.
Department of Molecular Biology, Davit Tvildiani Medical University, Tbilisi, Georgia.
Front Med (Lausanne). 2020 Jan 9;6:305. doi: 10.3389/fmed.2019.00305. eCollection 2019.
A 66-year-old patient with aortic stenosis was scheduled for an aortic valve replacement and coronary artery bypass surgery. Anesthesia was induced by intravenous injection of midazolam, fentanyl, and propofol. After administration of rocuronium, he developed anaphylactic shock, which was diagnosed by clinical signs, vital parameters, and unresponsiveness to the usual vasopressors. After 30 min of cardiopulmonary resuscitation, the patient survived without any neurological deficits. This case is a reminder that early recognition and treatment of intraoperative hypersensitivity reactions are imperative. Anesthetists should also receive simulation training to achieve an adequate experience in a safe environment. With a well-trained team, it is possible to save the life of patients with aortic stenosis.
一名66岁的主动脉瓣狭窄患者计划接受主动脉瓣置换术和冠状动脉搭桥手术。通过静脉注射咪达唑仑、芬太尼和丙泊酚诱导麻醉。给予罗库溴铵后,他发生了过敏性休克,通过临床体征、生命体征参数以及对常用血管升压药无反应进行诊断。经过30分钟的心肺复苏,患者存活下来,没有任何神经功能缺损。该病例提醒我们,术中过敏反应的早期识别和治疗至关重要。麻醉医生也应接受模拟训练,以便在安全环境中获得足够的经验。拥有一支训练有素的团队,就有可能挽救主动脉瓣狭窄患者的生命。