Cunningham Julie J, Braun Andrew S, Hussey Patrick, Momaya Amit, Kukreja Promil
School of Medicine, University of Alabama at Birmingham (UAB), Birmingham, USA.
Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham (UAB), Birmingham, USA.
Cureus. 2024 Feb 8;16(2):e53862. doi: 10.7759/cureus.53862. eCollection 2024 Feb.
Patients with hypertrophic obstructive cardiomyopathy (HOCM) who are scheduled for elective, noncardiac surgery present a distinctive challenge for perioperative healthcare providers. The use of general anesthesia and neuraxial anesthesia carries the risk of unpredictable hemodynamic changes and potential complications. Regional anesthesia (RA) emerges as a prudent and effective option for HOCM patients. RA provides advantages such as minimizing hemodynamic fluctuations, avoiding intubation, reducing pharmacologic side effects, facilitating enhanced recovery after surgery, and contributing to greater patient satisfaction. We share the case of a 15-year-old individual diagnosed with HOCM and exercise intolerance, undergoing arthroscopic repair for right patellar instability. In this instance, the patient received preoperative peripheral nerve blocks for surgical anesthesia and underwent repair utilizing monitored anesthesia care (MAC) with a dexmedetomidine (DEX) infusion.
计划接受择期非心脏手术的肥厚性梗阻性心肌病（HOCM）患者给围手术期医疗服务提供者带来了独特的挑战。全身麻醉和神经轴索麻醉的使用存在血流动力学变化不可预测和潜在并发症的风险。区域麻醉（RA）成为HOCM患者谨慎且有效的选择。RA具有诸多优势，如将血流动力学波动降至最低、避免插管、减少药物副作用、促进术后恢复以及提高患者满意度。我们分享一例15岁被诊断为HOCM且运动不耐受的患者，因右髌骨不稳定接受关节镜修复手术的病例。在此病例中，患者接受了术前外周神经阻滞用于手术麻醉，并在右美托咪定（DEX）输注的监护麻醉管理（MAC）下进行了修复手术。
