[General anesthesia for a patient with pulmonary hypertension, bronchial asthma and obesity].
The management of the patient with pulmonary hypertension is a challenge for the anesthesiologists because the risk of right-sided heart failure is markedly increased. We experienced a case of general anesthesia for a patient with pulmonary hypertension (mean pulmonary arterial pressure 39 mmHg), bronchial asthma and obesity. A 31-year-old woman was scheduled for arytenoid rotation for left recurrent nerve palsy. We applied routine monitors (noninvasive blood-pressure, five-lead electrocardiogram, pulse oximeter), and direct blood pressure monitoring through the radial artery. Anesthesia was induced with midazolam 4 mg, fentanyl 100 microg and sevoflurane 5%, and maintained with sevoflurane (1-2%) and nitrous oxide in oxygen. Surgery was completed in 100 minutes without any complications. We could successfully perform general anesthesia in a patient complicated by pulmonary hypertension, bronchial asthma and obesity, without invasive right-sided heart catheterization.
Nakamura
Shinji
S
Department of Anesthesiology, The University of Tokyo, Faculty of Medicine, Tokyo.
Nishiyama
Tomoki
T
Hanaoka
Kazuo
K
D000328:Adult; D000768:Anesthesia, General / Q000379:methods*; D001193:Arytenoid Cartilage / Q000601:surgery; D001249:Asthma / Q000150:complications*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications*; D009765:Obesity / Q000150:complications*; D014826:Vocal Cord Paralysis / Q000601:surgery