冠状动脉粥样硬化性心脏病合并心律失常老年患者行经鼻内镜巨大垂体瘤切除术麻醉管理1例

Anesthesia management in elderly patient with coronary heart disease and arrhythmia undergoing giant pituitary adenoma resection via endoscopic endonasal approach:A case report

心脏病患者接受非心脏手术时,麻醉与手术并发症和死亡风险较非心脏病患者更高。术前手术方式、患者术前评估和准备对于提高麻醉手术安全性和加快患者术后康复均具有重要意义。此例患者术前合并冠状动脉粥样硬化性心脏病(三支病变)、心律失常、频发室性期前收缩二尖瓣重度反流、陈旧性脑梗、低钾血症,术中通过维持重要脏器灌注以及采取纠正电解质、抗心律失常、抗炎和抗应激、保温和抗恶心呕吐等综合处理,患者顺利平稳完成手术,治愈出院。

Cardiac patients undergoing non⁃cardiac surgery have a higher risk of anesthesia and surgical complications and mortality than non⁃cardiac patients.Preoperative evaluation and preparation are of great importance to improve the safety of anesthesia surgery and speed up patient recovery after surgery.In the current article,the patient presented coronary heart disease(three⁃vessel disease),arrhythmia,frequent ventricular premature beats,severe mitral regurgitation,old cerebral infarction,and hypokalemia before surgery.During the surgery,the perfusion of vital organs was maintained,and electrolyte correction,anti⁃arrhythmia,anti⁃inflammation and anti⁃stress treatment,heat preservation and anti⁃nausea and vomiting were performed.The patient smoothly completed the surgery and was cured and discharged.