#36509脊髓麻醉经尿道切除严重无症状主动脉瓣球囊成形术后狭窄的病人

Magdalena Palian, Linda Perica, Mateja Ulamec, Nataša Margaretić Piljek, Eleonora Goluža, Slobodan Mihaljević
{"title":"#36509脊髓麻醉经尿道切除严重无症状主动脉瓣球囊成形术后狭窄的病人","authors":"Magdalena Palian, Linda Perica, Mateja Ulamec, Nataša Margaretić Piljek, Eleonora Goluža, Slobodan Mihaljević","doi":"10.1136/rapm-2023-esra.438","DOIUrl":null,"url":null,"abstract":"<h3></h3> <b>Please confirm that an ethics committee approval has been applied for or granted:</b> Not relevant (see information at the bottom of this page) <h3>Background and Aims</h3> One of the most prevalent serious valve disease problems is aortic stenosis. Patients with significant AS are often advised against receiving neuraxial anesthesia because they won’t be able to handle the crucial decrease in coronary perfusion pressure. We present a case of a successful transurethral resection under spinal anesthesia in a patient with severe asymptomatic AS which has been managed with balloon aortic valvuloplasty prior to the procedure. <h3>Methods</h3> An 81-year-old male, with a history of prostate cancer and a condition after prostatectomy, new-onset deep vein thrombosis of the left iliac vein, and newly detected severe asymptomatic aortic stenosis, was admitted to the hospital for a planned TUR due to tumor process of the urinary bladder. Echocardiography revealed preserved systolic function of the left ventricle, with severe aortic stenosis. In this case, TAVI was not indicated, so it was concluded that BAV would be performed to reduce the anesthetic risk. Balloon dilatation of the aortic valve was successfully performed. After a month from BAV, the patient was again admitted to the hospital for a planned surgical procedure. For TUR, a mixture of 0.5% bupivacaine, 40% glucose, and fentanyl was applied intrathecally at the L4-L5 level with a 27G needle. <h3>Results</h3> During the procedure the patient was stable, and TUR was done without any adverse effects. The patient was discharged home three days after surgery in good general condition. <h3>Conclusions</h3> In conclusion, our case report is evidence of successful outcome with spinal anesthesia in patient with adequately managed severe AS.","PeriodicalId":80519,"journal":{"name":"Archaeologia aeliana, or, Miscellaneous tracts relating to antiquity","volume":"92 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"#36509 Spinal anesthesia for transurethral resection in a patient with severe asymptomatic aortic stenosis after balloon aortic valvuloplasty\",\"authors\":\"Magdalena Palian, Linda Perica, Mateja Ulamec, Nataša Margaretić Piljek, Eleonora Goluža, Slobodan Mihaljević\",\"doi\":\"10.1136/rapm-2023-esra.438\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3></h3> <b>Please confirm that an ethics committee approval has been applied for or granted:</b> Not relevant (see information at the bottom of this page) <h3>Background and Aims</h3> One of the most prevalent serious valve disease problems is aortic stenosis. Patients with significant AS are often advised against receiving neuraxial anesthesia because they won’t be able to handle the crucial decrease in coronary perfusion pressure. We present a case of a successful transurethral resection under spinal anesthesia in a patient with severe asymptomatic AS which has been managed with balloon aortic valvuloplasty prior to the procedure. <h3>Methods</h3> An 81-year-old male, with a history of prostate cancer and a condition after prostatectomy, new-onset deep vein thrombosis of the left iliac vein, and newly detected severe asymptomatic aortic stenosis, was admitted to the hospital for a planned TUR due to tumor process of the urinary bladder. Echocardiography revealed preserved systolic function of the left ventricle, with severe aortic stenosis. In this case, TAVI was not indicated, so it was concluded that BAV would be performed to reduce the anesthetic risk. Balloon dilatation of the aortic valve was successfully performed. After a month from BAV, the patient was again admitted to the hospital for a planned surgical procedure. For TUR, a mixture of 0.5% bupivacaine, 40% glucose, and fentanyl was applied intrathecally at the L4-L5 level with a 27G needle. <h3>Results</h3> During the procedure the patient was stable, and TUR was done without any adverse effects. The patient was discharged home three days after surgery in good general condition. <h3>Conclusions</h3> In conclusion, our case report is evidence of successful outcome with spinal anesthesia in patient with adequately managed severe AS.\",\"PeriodicalId\":80519,\"journal\":{\"name\":\"Archaeologia aeliana, or, Miscellaneous tracts relating to antiquity\",\"volume\":\"92 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archaeologia aeliana, or, Miscellaneous tracts relating to antiquity\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1136/rapm-2023-esra.438\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archaeologia aeliana, or, Miscellaneous tracts relating to antiquity","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/rapm-2023-esra.438","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

背景和目的主动脉瓣狭窄是最常见的严重瓣膜疾病之一。严重的AS患者通常被建议不要接受轴向麻醉,因为他们将无法处理冠状动脉灌注压的关键下降。我们提出了一个病例成功经尿道切除脊髓麻醉下的病人有严重的无症状的AS已处理与球囊主动脉瓣成形术之前。方法1例81岁男性,前列腺癌病史及前列腺切除术后病情,新发左髂静脉深静脉血栓形成,新发现严重无症状主动脉瓣狭窄,因膀胱肿瘤进展而住院,计划行TUR。超声心动图显示左心室收缩功能保留,主动脉狭窄严重。本例患者未行TAVI,因此认为应行BAV以降低麻醉风险。主动脉瓣球囊扩张术成功。BAV一个月后,患者再次入院接受计划的外科手术。对于TUR,使用27G针头在L4-L5水平鞘内施用0.5%布比卡因,40%葡萄糖和芬太尼的混合物。结果术中患者病情稳定,术后无不良反应。患者术后3天出院,总体情况良好。总之,我们的病例报告证明了脊髓麻醉治疗严重AS患者的成功结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
#36509 Spinal anesthesia for transurethral resection in a patient with severe asymptomatic aortic stenosis after balloon aortic valvuloplasty

Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page)

Background and Aims

One of the most prevalent serious valve disease problems is aortic stenosis. Patients with significant AS are often advised against receiving neuraxial anesthesia because they won’t be able to handle the crucial decrease in coronary perfusion pressure. We present a case of a successful transurethral resection under spinal anesthesia in a patient with severe asymptomatic AS which has been managed with balloon aortic valvuloplasty prior to the procedure.

Methods

An 81-year-old male, with a history of prostate cancer and a condition after prostatectomy, new-onset deep vein thrombosis of the left iliac vein, and newly detected severe asymptomatic aortic stenosis, was admitted to the hospital for a planned TUR due to tumor process of the urinary bladder. Echocardiography revealed preserved systolic function of the left ventricle, with severe aortic stenosis. In this case, TAVI was not indicated, so it was concluded that BAV would be performed to reduce the anesthetic risk. Balloon dilatation of the aortic valve was successfully performed. After a month from BAV, the patient was again admitted to the hospital for a planned surgical procedure. For TUR, a mixture of 0.5% bupivacaine, 40% glucose, and fentanyl was applied intrathecally at the L4-L5 level with a 27G needle.

Results

During the procedure the patient was stable, and TUR was done without any adverse effects. The patient was discharged home three days after surgery in good general condition.

Conclusions

In conclusion, our case report is evidence of successful outcome with spinal anesthesia in patient with adequately managed severe AS.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
#35807 Erector spinae block for percutaneous kyphoplasty anesthetic management in high-risk patients: a case report #35918 A randomized control trial to evaluate the effects of Ketofol versus propofol on cerebral oxygenation in patients undergoing Trans-sphenoidal pituitary surgery under total intravenous anesthesia #35931 Regional anaesthesia for intubation and maintenance in myasthenia gravis patient with bilateral renal calculi #34666 Case report: Ablation of renal tumour in high bmi patient under single shot paravertebral and remifentanil #35938 Venovenous ECMO in near fatal ashtma: case report
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1