在神经轴索麻醉下进行腹疝修补术。
Ventral hernia repair under neuraxial anesthesia.
作者信息
Germanò Paolo, Siboni Stefano, Milito Pamela, Mautone Gaetano, Resta Marco, Bonavina Luigi
机构信息
Department of Biomedical Sciences for Health, IRCCS Policlinico San Donato, Division of General and Foregut Surgery, University of Milan, Piazza Malan 1, 20097 San Donato Milanese (Milano), Italy.
Department of Biomedical Sciences for Health, IRCCS Policlinico San Donato, Division of General and Foregut Surgery, Anesthesiology and Intensive Care Unit, University of Milan, San Donato Milanese (Milano), Italy.
出版信息
Eur Surg. 2022;54(1):54-58. doi: 10.1007/s10353-021-00731-x. Epub 2021 Jul 20.
BACKGROUND
Acute strangulated ventral hernia is associated with operative morbidity and mortality. General anesthesia may increase the operative risk, especially in morbidly obese and COVID-19-positive individuals.
METHODS
A 67-year-old woman with body mass index (BMI) 51 kg/m, hospitalized for SARS-CoV-2-related interstitial pneumonia and renal failure, presented with acute abdominal pain, nausea, vomiting, and abdominal tenderness secondary to giant ventral hernia strangulation.
RESULTS
Due to the suspicion of vascular bowel compromise at contrast-enhanced CT scan, urgent open surgical repair surgery was performed under spinal anesthesia and Venturi mask support. There was no need for an intensive care unit (ICU) stay. Postoperative course was uneventful, and the patient was transferred to a rehabilitation center on postoperative day 10.
CONCLUSION
Although some anesthetists and surgeons may be reluctant to use regional anesthesia for both emergent and elective ventral hernia repair, this may represent an excellent option in obese patients with a high respiratory risk.
背景
急性绞窄性腹外疝与手术 morbidity 和 mortality 相关。全身麻醉可能会增加手术风险，尤其是在病态肥胖和新冠病毒检测呈阳性的个体中。
方法
一名 67 岁女性，体重指数（BMI）为 51 kg/m²，因与 SARS-CoV-2 相关的间质性肺炎和肾衰竭住院，因巨大腹外疝绞窄出现急性腹痛、恶心、呕吐和腹部压痛。
结果
由于在增强 CT 扫描中怀疑有肠血管受损，在脊髓麻醉和文丘里面罩支持下进行了紧急开放手术修复。无需入住重症监护病房（ICU）。术后过程顺利，患者在术后第 10 天转至康复中心。
结论
尽管一些麻醉医生和外科医生可能不愿在急诊和择期腹外疝修复中使用区域麻醉，但这对于呼吸风险高的肥胖患者可能是一个极佳的选择。
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