Bevan D R
Anaesthesia. 1979 Oct;34(9):866-73. doi: 10.1111/j.1365-2044.1979.tb08537.x.
Autonomic failure in patients with the Shy-Drager syndrome may produce cardiovascular instability during anaesthesia and surgery. The syndrome is reviewed and the anaesthetic management of a case is described. The choice between general and regional anaesthesia seems to be less important than adequate cardiovascular monitoring and the maintenance of blood pressure with intravenous fluids. Sympathomimetic drugs, if used at all, should be administered in very dilute solutions to avoid hypertension from denervation hypersensitivity. In the postoperative period, symptoms from orthostatic hypotension may be severe and their control requires prolonged postural training, by elevation of the head of the bed, and therapy with 9-alpha-fludrocortisone.
夏伊-德雷格综合征患者的自主神经功能衰竭可能在麻醉和手术期间导致心血管不稳定。本文对该综合征进行了综述，并描述了一例病例的麻醉管理。全身麻醉和区域麻醉之间的选择似乎不如充分的心血管监测以及通过静脉输液维持血压重要。拟交感神经药物（若使用）应以极稀溶液给药，以避免去神经超敏反应引起的高血压。在术后阶段，体位性低血压的症状可能很严重，控制这些症状需要通过抬高床头进行长期体位训练，以及使用9-α-氟氢可的松进行治疗。
