Anesthetic management for emergent craniotomy in a patient with Eisenmenger's syndrome: A case report.
10.4097/kjae.2009.57.5.666
- Author:
Kum Hee CHUNG
1
;
Seung Ho KIM
;
Duk Hee CHUN
;
Jong Yun LEE
;
Seong Cheol PARK
;
Chung Hyun PARK
;
Min Goo KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, CHA University School of Medicine, Pocheon, Korea. anesthpark@hanmail.net
- Publication Type:Case Report
- Keywords:
Eisenmenger's syndrome;
Milrinone;
Norepinephrine
- MeSH:
Abscess;
Androstanols;
Anesthesia;
Anti-Bacterial Agents;
Catheters;
Craniotomy;
Eisenmenger Complex;
Etomidate;
Femoral Vein;
Fentanyl;
Fever;
Heart Ventricles;
Humans;
Hypogonadism;
Intensive Care Units;
Male;
Midazolam;
Milrinone;
Mitochondrial Diseases;
Norepinephrine;
Ophthalmoplegia;
Vascular Resistance;
Young Adult
- From:Korean Journal of Anesthesiology
2009;57(5):666-669
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Eisenmenger's syndrome describes the elevation of pulmonary arterial (PA) pressure to the systemic level caused by an increased pulmonary vascular resistance with reversed or bi-directional shunt through an intracardiac or aortopulmonary communication. We report a case of an emergent craniotomy for cerebellar abscess in a 21-year-old male patient with Eisenmenger syndrome secondary to Large VSD. A PA catheter was inserted via right femoral vein, but could not be advanced pass the pulmonic valve. After futile attempts to place the catheter tip in the right ventricle. Anesthesia was induced with etomidate, rocuronium, midazolam and fentanyl and maintained with only high dose fentanyl. Milinone and norepinephrine were infused continuously to decrease right to left shunt. He was transferred to the intensive care unit under intubated state and treated with antibiotics for a few days due to intermittent high fever. The operation ended without major complications and the patient was discharged 42 days later.
