title: Peri-operative trans-oesophageal echocardiography and nitric oxide during general anaesthesia in a patient with Eisenmenger's syndrome.
abstract: We describe the peri-operative care of a patient with Eisenmenger's syndrome presenting for laparotomy. These patients require techniques to prevent the potential increase in intracardiac shunt caused by anaesthesia, by minimising increases in pulmonary artery pressure and reductions in systemic vascular resistance. The successful use of combined epidural and general anaesthesia with elective use of inhaled nitric oxide as a pulmonary vasodilator, and intra-operative trans-oesophageal echocardiography is described.
authors.affiliation: Department of Anaesthetics and Critical Care Medicine, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK. christopher.bouch@ukonline.co.uk
authors.forename: D C
authors.initials: DC
authors.lastname: Bouch
authors.forename: C M
authors.initials: CM
authors.lastname: Allsager
authors.forename: N
authors.initials: N
authors.lastname: Moore
mesh_terms: D000328:Adult; D000768:Anesthesia, General / Q000379:methods*; D003424:Crohn Disease / Q000150:complications / Q000601:surgery; D017548:Echocardiography, Transesophageal; D004541:Eisenmenger Complex / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D009569:Nitric Oxide / Q000627:therapeutic use*; D019990:Perioperative Care / Q000379:methods*; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D014665:Vasodilator Agents; D009569:Nitric Oxide