Korean J Anesthesiol.  1988 Aug;21(4):597-604. 10.4097/kjae.1988.21.4.597.

Anesthetic management for Surgery of the Ascending Aortic Aneurysm

• Lee YW
• Shin JS
• Nam SH
• Bang SO
• Oh HK

• KMID: 1933132
• DOI: http://doi.org/10.4097/kjae.1988.21.4.597

Abstract

Fifteen cases of corrective operation for the ascending aortic aneurysm performed under general anesthesia from 1979 to 1985 in Severance Hospital were studied retrospectively. There were ten male patients and 5 female and their average age were 36.6 years(range 25~50 years). Most of the patients showed aortic regurgitation. Thus the anesthetic management involved consideration for patients with aortic dissection combined with aortic incompetence(annuloaortic ectasia). Patients were premedicated with atropine or glycopyrrolate in 14 cases and a combination of triflupromazine, hydroxyzine, diazepam and pethidine in 13 cases or a combination of hydroxyzine and morphine in 2 cases. Anesthesia was induced with thiopental sodium and/or diazepam and/or midazolam and/or morphine IV. Morphine and a mixture of 50% nitrous oxide and oxygen was administered for maintenance of anesthesia. Supplementary volatile anesthetics were inhaled as needed. Vasodilating therapy and avoidance of bradycardia during anesthesia are the most importance considerations for the reduction of left ventricular wall tension and to maximize the myocardial oxygen supply while maintaining cardiac output. Operative complications were reoperation due to bleeding in four cases, myocardial infarction in two cases, pericardial tamponade and urethral track infection in one case each. One patient died of sepsis. Fourteen patients improved in their heart size and function.

Keyword

Ascending aortic aneurysm; Annulosortic ectasia; Anesthetic management

MeSH Terms

Anesthesia
Anesthesia, General
Anesthetics
Aortic Aneurysm*
Aortic Valve Insufficiency
Atropine
Bradycardia
Cardiac Output
Cardiac Tamponade
Diazepam
Female
Glycopyrrolate
Heart
Hemorrhage
Humans
Hydroxyzine
Male
Meperidine
Midazolam
Morphine
Myocardial Infarction
Nitrous Oxide
Oxygen
Reoperation
Retrospective Studies
Sepsis
Thiopental
Triflupromazine
Anesthetics
Atropine
Diazepam
Glycopyrrolate
Hydroxyzine
Meperidine
Midazolam
Morphine
Nitrous Oxide
Oxygen
Thiopental
Triflupromazine