Gurajala I, Reddy G P, Vejendla K, Vanaja V, Verma G S R, Jonnavithula N
Department of Anaesthesiology and Intensive Care Nizam's Institute of Medical Sciences Hyderabad India.
Department of Surgical Gastroenterology Nizam's Institute of Medical Sciences Hyderabad India.
Anaesth Rep. 2024 Oct 2;12(2):e12330. doi: 10.1002/anr3.12330. eCollection 2024 Jul-Dec.
A 35-year-old woman with severe pulmonary arterial hypertension underwent open hemicolectomy with cholecystectomy under combined general and epidural anaesthesia. Intra-operative pulmonary artery pressure, as measured by Swan-Ganz catheter, was suprasystemic and managed with inodilators. She developed postoperative right ventricular dysfunction requiring inotropes, incremental pulmonary vasodilators and prolonged oxygen supplementation. One year after surgery, she is recurrence-free with oxygen saturations of 88-90% on air. This case highlights that with meticulous care and multidisciplinary team input, patients with severe pulmonary arterial hypertension can have favourable outcomes after major cancer surgery.
一名35岁的重度肺动脉高压女性患者在全身麻醉联合硬膜外麻醉下接受了半结肠切除术和胆囊切除术。术中通过 Swan-Ganz 导管测量的肺动脉压高于体循环压力，使用血管活性药物进行处理。她术后出现右心室功能障碍，需要使用正性肌力药物、增加肺血管扩张剂并延长吸氧时间。术后一年，她未复发，空气中氧饱和度为88%-90%。该病例表明，通过精心护理和多学科团队协作，重度肺动脉高压患者在接受重大癌症手术后可获得良好预后。
