Intraoperative pulmonary thromboembolism.
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概要
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Fifty five years old woman was undergone the varicose vein operation of the right lower extremity, with epidural anesthesia and light sedation. About 2 hours after anesthetic procedure, she complained the chest discomfort and dyspnea, without hypotention and dysrythmia. These symptoms suggested us the onset of the pulmonary embolism. The diagnosis was establisched by scintigram and digital subtraction angiography (DSA) of pulmonary blood flow. The Swan-Ganz catheter was inserted through the internal jugular vein, for the measurement of pulmonary arterial pressure and the infusion route of thrombolitic and anticoagulating agents, such as urokinase and heparine. The general condition and the picture of the pulmonary scintigram was recovered gradually, in spite of the withdrawal of these therapies because of bleeding from the surgical wound on the two days after operation.We could suggest that DSA might be the first choice examination for the diagnosis of pulmonary thromboembolism, because of its lower invasiveness and the ability of immediate application, espessialy in a patient with cadiovascular depression.
- 日本臨床麻酔学会の論文
日本臨床麻酔学会 | 論文
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