Sony Sony, Shekhar Shivam, Walikar Beeraling N, Shiwali Shiwali
Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, IND.
Cureus. 2022 Dec 24;14(12):e32906. doi: 10.7759/cureus.32906. eCollection 2022 Dec.
Non-operating room anesthesia challenges the anesthesiologist to deliver the same high-quality care as in the operating room. Amid the perplexity of the unfamiliar environment, scarcity of ancillary staff, and physical limitations, a distressing signal from pulse oximetry can cause a scare. We present a case of Raynaud's phenomenon in a patient posted for cystogastrostomy in the endoscopic retrograde cholangiopancreatography suite. The patient had pulmonary complications, a left-sided pleural effusion with underlying lung collapse related to pancreatitis; thus, a non-reassuring reading from pulse oximetry caused alarm. The patient had sinus tachycardia, with a heart rate of 104 beats per minute, and a blood pressure of 100/60 mmHg. We provided supplemental oxygen to the patient while planning for emergency tracheal intubation because of a low peripheral oxygen saturation of 87%. The patient was conscious during this time, prompting us to check the pulse oximeter probe. We then noticed that patient's digits had turned blue/pale. A sudden attack of Raynaud's in the perioperative period can mislead the caregivers, and an unwarranted state of panic can ensue.
非手术室麻醉要求麻醉医生提供与手术室相同的高质量护理。在陌生环境的困惑、辅助人员的短缺和身体限制中，脉搏血氧饱和度仪发出的令人担忧的信号可能会引起恐慌。我们报告一例在内镜逆行胰胆管造影术套房接受膀胱胃造口术的患者出现雷诺现象的病例。该患者有肺部并发症，因胰腺炎导致左侧胸腔积液并伴有肺萎陷；因此，脉搏血氧饱和度仪显示的令人不安的读数引起了警报。患者窦性心动过速，心率为每分钟104次，血压为100/60 mmHg。由于外周血氧饱和度低至87%，我们在为患者提供补充氧气的同时计划进行紧急气管插管。在此期间患者神志清醒，这促使我们检查脉搏血氧饱和度仪探头。然后我们注意到患者的手指已经变蓝/苍白。围手术期突然发作的雷诺现象可能会误导护理人员，并可能导致不必要的恐慌状态。
