[The effects of thoracic epidural anesthesia combined with phentolamine infusion in a patient with low left ventricular ejection fraction undergoing resection of aortic abdominal aneurysm].
The subject was a 73 year old man scheduled for resection of abdominal aortic aneurysm. The patient had a past history of myocardial infarction and his left ventricular ejection fraction was 21%. Anesthesia was maintained with thoracic epidural anesthesia combined with light general anesthesia using NLA technique. Phentolamine was infused for after-load reduction. We maintained the intravascular volume with infusion therapy and mild hemodilution was performed. As the result of these procedures, systemic vascular resistance decreased and cardiac index increased after the induction of anesthesia. Forrester classification was subset I at any point during the surgery. Hemodynamic changes were not significant after clamping and unclamping of the aorta. We conclude that successful anesthetic management of this patient was due to the epidural anesthesia and combined use of phentolamine as a vasodilator.
Arai
M
M
Department of Anesthesiology, Kitasato University School of Medicine, Sagamihara.
Takenaka
T
T
Kato
S
S
D000368:Aged; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D006333:Heart Failure / Q000517:prevention & control; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000503:physiopathology; D010646:Phentolamine / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000517:prevention & control; D011229:Preanesthetic Medication; D013318:Stroke Volume; D014665:Vasodilator Agents / Q000008:administration & dosage*; D016277:Ventricular Function, Left
D014665:Vasodilator Agents; D010646:Phentolamine