title: Monitored anesthesia care with dexmedetomidine of a patient with severe pulmonary arterial hypertension for inguinal hernioplasty.
abstract: The presence of severe pulmonary arterial hypertension (PAH) is a significant risk factor of major perioperative cardiovascular complications in patients undergoing even non-cardiac surgery under anesthetic management. The most important aspect of perioperative care of PAH patients is to avoid pulmonary hypertensive crisis, which can be induced by alveolar hypoxia, hypoxemia, hypercarbia, metabolic acidosis, airway manipulations, and activation of the sympathetic nervous system by noxious stimuli. We report a case of successful monitored anesthesia care supplemented by dexmedetomidine for inguinal hernioplasty of a patient with severe PAH secondary to congenital heart disease.
authors.affiliation: Department of Anesthesia, Kyoto University Hospital, 54 Shogoin-Kawaracho, Sakyo-Ku, Kyoto, 606-8507, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Shinohara
authors.forename: Kiichi
authors.initials: K
authors.lastname: Hirota
authors.forename: Masami
authors.initials: M
authors.lastname: Sato
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kakuyama
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Fukuda
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000494:pharmacology*; D000328:Adult; D000758:Anesthesia / Q000379:methods*; D020927:Dexmedetomidine / Q000494:pharmacology*; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology*; D008297:Male; D016343:Monitoring, Intraoperative
chemical_list: D000316:Adrenergic alpha-Agonists; D020927:Dexmedetomidine
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