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Anesthetic Induction in a Sitting Position for a Patient with Congestive Heart Failure

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A 67-year-old woman with severe congestive heart failure (New York Heart Association, NYHA class IV) was set to receive general anesthesia for cardiac surgery. For several months, she had been in a constant sitting position from which the slightest change evoked dyspnea. A patient in such a condition is rarely considered a candidate for general anesthesia, because such patients are never eligible for any type of surgery other than that used to fix the heart problem itself. We report this case to explain how anesthesia was induced with the patient sitting in a crouching position and discuss other methods of induction that can probably be used in similar situations.

Abstract

A 67-year-old woman with severe congestive heart failure (New York Heart Association, NYHA class IV) was set to receive general anesthesia for cardiac surgery. For several months, she had been in a constant sitting position from which the slightest change evoked dyspnea. A patient in such a condition is rarely considered a candidate for general anesthesia, because such patients are never eligible for any type of surgery other than that used to fix the heart problem itself. We report this case to explain how anesthesia was induced with the patient sitting in a crouching position and discuss other methods of induction that can probably be used in similar situations.

참고문헌 (6)

  1. G. Edward Morgan, Jr, "Clinical Anesthesiology", pp.441~489 (2006), Mcgraw-Hill
  2. Anthony S. Fauci, "Harrison's principles of internal medicine", pp.1358~1368 (2003), McGraw-Hill
  3. Sullivan MJ, "Exercise intolerance in patients with chronic heart failure", Prog Cardiovasc Dis, 38(1), pp.1~22 (1995)
  4. Roussos C, "Respiratory failure", Eur Respir J Suppl, 47, pp.3s~14s (2003)
  5. Suzuki S, "Prevalence and prognosis of patients with atrial fibrillation in Japan: a prospective cohort of Shinken Database 2004", Circ J, 72(6), pp.914~920 (2008)
  6. Maisel WH, "Atrial fibrillation in heart failure: epidemiology, pathophysiology, and rationale for therapy", Am J Cardiol, 91(6A), pp.2D~8D (2003)

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