PDF(Pubmed)
Abstract：
Patients with severe cardiopulmonary morbidity present a unique challenge to peri- and intraoperative providers. Inducing general anesthesia in this patient population poses the risk of adverse events that could lead to poor surgical outcomes, prolonged debilitation, or death. Therefore, it is important that anesthesiologists become comfortable with preoperative evaluation as well as alternative strategies to providing surgical anesthesia. This case report details the clinical course of a patient with severe cardiopulmonary morbidity who underwent open inguinal hernia repair without oral or intravenous sedation after receiving multi-level paravertebral blocks in addition to isolated ilioinguinal and iliohypogastric nerve blocks. This medically challenging case provides educational value regarding preoperative evaluation, pertinent anatomy and innervation, and the importance of patient-centered care and communication.
摘要：
患有严重心肺疾病的患者对围手术期和术中提供者提出了独特的挑战。在该患者人群中诱导全身麻醉会带来不良事件的风险，这些不良事件可能导致不良的手术结果。长时间的衰弱，或死亡。因此,重要的是,麻醉医师要适应术前评估以及提供手术麻醉的替代策略.该病例报告详细介绍了一名患有严重心肺疾病的患者的临床过程，该患者除了接受孤立的髂腹股沟和髂腹下神经阻滞外，还接受了多层椎旁阻滞，没有进行口服或静脉镇静的开放式腹股沟疝修补术。这个医学上具有挑战性的案例提供了有关术前评估的教育价值，相关的解剖学和神经支配，以及以患者为中心的护理和沟通的重要性。
