歲月麻醉

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心臟病患者手術的麻醉風險

最近與外科M&M有一例AS(ankylosing spondilitis)與CHF(congestion heart failure),術後發生complication & mortality. Meeting 的ppt檔案在:https://docs.google.com/present/edit?id=0Acx0IqdMJQbJZGY4OTQ1bXhfNTE0YzhoZ3ZoaHE&hl=en_US

丁香園也有一例放置支架患者進行腹腔鏡手術後,發生急性心肌梗塞的病例。 對於這些屬於intermediate risk predictors 的族群,在制定整個麻醉方案時,是應該多一點心思啊!
原始連結:冠心病病人腹腔鏡手術術後急性心梗發作死亡 [

患者男,52歲,體重71kg,神智清楚,發育營養可。
既往健康狀況一般,有「支氣管哮喘」病史33年,一直正規激素治療,近兩年未再發,否認「糖尿病、高血壓」等慢性病是,否認傳染病史,否認重大外傷史。「冠心病」病史四年。於RCA遠端-左室病變處、LAD中段、近段病變處、LCX病變處置入四枚支架。支架置入後一直服用波利維阿斯匹林抗凝治療。心絞痛症狀分別於09年10年各發作一次,介入治療後好轉,近一年無心絞痛症狀再發,平時可耐受體力活動,心功能Ⅰ級。

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