老年房颤患者行非心脏手术的麻醉处理体会

Experience of Anesthesia Management on Non-cardiac Surgery in Elderly Patients with Atrial Fibrillation

目的分析老年房颤患者施行非心脏手术的麻醉处理过程,探讨围手术期的监测手段和治疗措施。方法 28例老年房颤患者中,9例采用全身麻醉,14例采用椎管内阻滞,5例采用臂丛神经阻滞。其中23例患者术前接受抗心律失常药物治疗。结果 28例患者均安全度过围手术期。结论积极处理原发病,改善心功能,选择适当的麻醉方式以及药物,严密监测,及时纠正心律失常以及血流动力学紊乱,尽可能消除加重房颤的诱因,是病人安全度过围术期的重要保证。

Objective To analyze the anesthetic management on non-cardiac surgery in elderly patients with atrial fibrillation （AF） and explore the perioperative monitoring methods and treatment measures. Methods Among 28 elderly patients with AF, 9 cases received general anesthesia, 14 cases received the spinal block, 5 cases received brachial plexus block. 23 cases accepted antiarrhythmic drugs before the operation. Results All patients got through the perioperative period safely. Conclusions The following measures are the guarantee for geting through the perioperative period safety： positive treatment of the primary diseases, improvement of cardiac function, appropriate anesthetic technique and drugs, closely monitoring, timely correction of arrhythmia and hemodynamic disturbance, elimination of inducement for aggravating atrial fibrillation as much as possible.