一例特发性肺动脉高压伴晕厥史患者的围手术期管理：病例报告。
Perioperative Management of a Patient With Idiopathic Pulmonary Hypertension and a History of Syncope: A Case Report.
出版信息
Anesth Prog. 2024 May 3;71(1):29-33. doi: 10.2344/anpr-70-03-08.
Abstract
Pulmonary hypertension is characterized by higher-than-normal pulmonary arterial pressures. This case report describes the perioperative management of a male patient with idiopathic pulmonary hypertension and a history of vasovagal syncope during previous dental extractions with local anesthesia. He underwent successful extraction of a single tooth with intravenous moderate sedation using dexmedetomidine and midazolam as well as prilocaine with felypressin for local anesthesia. There are many considerations surrounding the anesthetic management of patients with pulmonary hypertension, including the need to maintain systemic blood pressure, avoid hypoxemia and hypercapnia, and ensure adequate analgesia.
摘要
肺动脉高压的特点是肺动脉压力高于正常水平。本病例报告描述了一名男性患者的围手术期管理，该患者患有特发性肺动脉高压，并有既往局部麻醉下拔牙时出现血管迷走神经性晕厥的病史。他在静脉中度镇静下使用右美托咪定和咪达唑仑以及含肾上腺素的普鲁卡因进行局部麻醉，成功地拔出了一颗牙齿。对于患有肺动脉高压的患者，麻醉管理有许多需要考虑的因素，包括维持全身血压、避免低氧血症和高碳酸血症以及确保足够的镇痛。
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