Kato T, Yokota M, Horie Y, Noda Y, Kamiyama F, Takahashi M
Department of Anesthesiology, Toyokawa City Hospital.
Masui. 1993 Aug;42(8):1227-9.
We report an 83 year-old male with pemphigoid who underwent replacement of a femoral neck prosthesis following femoral neck fracture. Problems associated with anesthetic management of patients with vesiculobullous diseases such as pemphigoid include fluid, electrolyte and protein loss, and secondary infection because of the fragility of the skin and mucous membranes. Avoidance of trauma to the skin and mucous membranes is therefore important. Intubation of the trachea may be hazardous because of the possibility of airway obstruction resulting from oropharyngeal and laryngeal bullae. The patient was successfully anesthetized with spinal anesthesia using 2.5 ml of tetracaine in a 0.4% solution of 0.45% NaCl. An evacutable mattress was used to protect the patient from pressure points in the lateral position, and to minimize the hazards from pressure by spreading the weight. Surgery proceeded uneventfully and the postoperative period was uncomplicated.
我们报告了一位83岁患有类天疱疮的男性患者，该患者在股骨颈骨折后接受了股骨颈假体置换术。与类天疱疮等水疱大疱性疾病患者的麻醉管理相关的问题包括液体、电解质和蛋白质流失，以及由于皮肤和粘膜脆弱而导致的继发感染。因此，避免皮肤和粘膜受到创伤很重要。气管插管可能具有危险性，因为口咽和喉大疱可能导致气道阻塞。该患者使用2.5毫升0.4%丁卡因加在0.45%氯化钠溶液中成功实施了脊髓麻醉。使用可抽空床垫保护处于侧卧位的患者免受压力点影响，并通过分散体重将压力危害降至最低。手术顺利进行，术后恢复过程无并发症。
