Schechter W S, Kim C, Martinez M, Gleason B F, Lund D P, Burrows F A
Department of Anesthesia, Children's Hospital, Boston, MA 02115, USA.
Can J Anaesth. 1995 May;42(5 Pt 1):404-8. doi: 10.1007/BF03015486.
The purpose of this clinical report is to discuss the anaesthetic management of a patient with end-stage cardiomyopathy. An eight-year-old boy sustained electro-mechanical dissociation following a "standard anaesthetic induction" but was subsequently successfully anaesthetized using a combination of etomidate, midazolam, lidocaine, vecuronium and glycopyrrolate. Anaesthetic techniques and their relationship to the specific category of cardiomyopathy (dilated, hypertrophic or restrictive) are discussed. The potential detrimental effects of anaesthetic sympatholysis, myocardial depression and negative chronotropy on cardiac output are explained.
本临床报告旨在探讨终末期心肌病患者的麻醉管理。一名8岁男孩在“标准麻醉诱导”后出现电机械分离，但随后使用依托咪酯、咪达唑仑、利多卡因、维库溴铵和格隆溴铵联合用药成功麻醉。文中讨论了麻醉技术及其与特定类型心肌病（扩张型、肥厚型或限制型）的关系。解释了麻醉性交感神经阻滞、心肌抑制和负性变时性对心输出量的潜在有害影响。
