Gozal Y, Ginosar Y, Gozal D
Department of Anesthesiology and Critical Care Medicine, Hadassah University, Hospital, Jerusalem, Israel.
Reg Anesth. 1995 May-Jun;20(3):246-8.
The case is presented of a 44-year-old woman with type I Takayasu's arteritis, undergoing total abdominal hysterectomy.
Her previous symptoms were related to subclavian and vertebral artery lesions that were treated surgically, and to right carotid stenosis (amaurosis fugax 1-year before the operation) that was not treated. Peripheral pulses were present and blood pressure monitoring was not a problem (invasive intra-arterial pressure monitoring was used). Neurologic monitoring was considered to be mandatory in this case and a computerized electroencephalography monitor was used, both to confirm the adequacy of anesthesia and, more importantly, to monitor unilateral cerebrovascular events.
The patient underwent surgery with combined epidural and general anesthesia, without any complications. The epidural block was used throughout the early postoperative period for analgesia.
The management of patients with Takayasu's arteritis requires a knowledge of the location and pathophysiology of vascular lesions.
本文介绍了一名44岁患有I型高安动脉炎的女性患者，该患者接受了全腹子宫切除术。
她之前的症状与经手术治疗的锁骨下动脉和椎动脉病变以及未经治疗的右颈动脉狭窄（术前1年出现一过性黑矇）有关。外周脉搏存在，血压监测不成问题（采用有创动脉内压力监测）。在该病例中，神经监测被认为是必要的，使用了计算机化脑电图监测仪，既用于确认麻醉的充分性，更重要的是用于监测单侧脑血管事件。
患者接受了硬膜外麻醉和全身麻醉联合的手术，未出现任何并发症。术后早期全程使用硬膜外阻滞进行镇痛。
高安动脉炎患者的管理需要了解血管病变的位置和病理生理学。
