RESUMEN
El número de pacientes con patología cardíaca congénita que se intervienen de cirugía no cardíaca está en aumento. El manejo de este tipo de pacientes en neurocirugía requiere de una planificación anestésico-quirúrgica minuciosa. La necesidad de intervención urgente junto con la presencia de una cardiopatía congénita evolucionada a síndrome de Eisenmenger, asociadas a una vía aérea difícil, van a suponer un reto para el anestesiólogo. La utilización de dexmedetomidina puede ser una alternativa. Presentamos el caso de una paciente con síndrome de Down y síndrome de Eisenmenger que fue sometida a un drenaje de absceso cerebral de urgencias siendo posteriormente reintervenida de forma programada. Se comparan las diferentes técnicas anestésicas empleadas en ambos procedimientos, analizando las implicaciones que tuvieron sobre las principales alteraciones fisiopatológicas que presentaba la paciente.(AU)
Adults patients with congenital heart disease increasingly present for non cardiac surgery. The anesthetic management this type of patients in neurosurgery requires a meticulous surgical anesthetic planning. The need for urgent intervention, with the presence of a congenital heart disease evolved to Eisenmenger Syndrome, associated to a difficult airway, is a challenge for the anesthesiologist. The use of dexmedetomidine may be a valid alternative. We present the case of a patient with Down syndrome, and Eisenmenger syndrome who underwent drainage of brain abscess from the emergency department and was subsequently scheduled for reintervention. We compare the different anesthetic techniques used in both procedures, analyzing the implications they had on the main physiopathological alterations presented by the patient.(AU)
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Neurocirugia , Síndrome de Down/complicaciones , Complejo de Eisenmenger/complicaciones , Dexmedetomidina , Pacientes Internos , Cirugía General , Anestesia , Anestesiología , Reanimación CardiopulmonarRESUMEN
Adults patients with congenital heart disease increasingly present for non cardiac surgery. The anesthetic management this type of patients in neurosurgery requires a meticulous surgical anesthetic planning. The need for urgent intervention, with the presence of a congenital heart disease evolved to Eisenmenger syndrome, associated to a difficult airway, is a challenge for the anesthesiologist. The use of dexmedetomidine may be a valid alternative. We present the case of a patient with Down syndrome, and Eisenmenger syndrome who underwent drainage of brain abscess from the emergency department and was subsequently scheduled for reintervention. We compare the different anesthetic techniques used in both procedures, analyzing the implications they had on the main physiopathological alterations presented by the patient.
Asunto(s)
Anestésicos , Síndrome de Down , Complejo de Eisenmenger , Cardiopatías Congénitas , Neurocirugia , Adulto , Síndrome de Down/complicaciones , Complejo de Eisenmenger/complicaciones , Complejo de Eisenmenger/cirugía , HumanosRESUMEN
Adults patients with congenital heart disease increasingly present for non cardiac surgery. The anesthetic management this type of patients in neurosurgery requires a meticulous surgical anesthetic planning. The need for urgent intervention, with the presence of a congenital heart disease evolved to Eisenmenger Syndrome, associated to a difficult airway, is a challenge for the anesthesiologist. The use of dexmedetomidine may be a valid alternative. We present the case of a patient with Down syndrome, and Eisenmenger syndrome who underwent drainage of brain abscess from the emergency department and was subsequently scheduled for reintervention. We compare the different anesthetic techniques used in both procedures, analyzing the implications they had on the main physiopathological alterations presented by the patient.
Asunto(s)
Laringe/cirugía , Terapia por Láser/efectos adversos , Enfisema Mediastínico/etiología , Neumotórax/etiología , Enfisema Subcutáneo/etiología , Humanos , Intubación Intratraqueal , Laringoscopía , Masculino , Enfisema Mediastínico/diagnóstico por imagen , Persona de Mediana Edad , Neumotórax/diagnóstico por imagen , Radiografía , Enfisema Subcutáneo/diagnóstico por imagenRESUMEN
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