심장 이식술을 시행받은 환자의 저비중 척추마취 - 증례 보고

• Published in: Korean journal of anesthesiology Vol. 35; no. 5; pp. 999 - 1002
• Main Authors: 배선준, Sun Joon Bai, 남용택, Yong Taek Nam, 이행철, Haeng Chul Lee, 구민우, Min Woo Koo
• Format: Journal Article
• Language: Korean
• Published: 대한마취통증의학회(구 대한마취과학회) 30.11.1998
• Subjects: Anesthesia; heart. Surgery; hypobaric spinal. Transplantation; total hip replacement
• ISSN: 2005-6419; 2005-7563

Heart transplantation is an accepted procedure for treatment of end-staged cardiac failure. A return to near-normal quality on life can be expected in many patients with a nonrejecting cardiac allograft, and many of these patients will return to the operating room for noncardiac surgical procedures. Anesthesiologists should be alert to recognizing problems caused by the presence of infection in immunosuppressed patients, modes of presentation of rejection phenomena and how transplanted organs, notably significantly denervated ones, may behave and respond under the pathophysiologic circumstance that arise during surgery, resuscitation and intensive care. The use of regional techniques require adequate preloading to avoid exaggerated hypotension and aseptic technique to avoid infection. Hypobaric spinal anesthesia has some benefit. It does not depress cardiovascular and respiratory system and keep adequate venous return by trendelenberg position. We report herein a case of successfully undergone total hip replacement in a patient who had previously undergone orthotopic heart transplantation under hypobaric spinal anesthesia. (Korean J Anesthesiol 1998; 35: 999∼1002)