PDF(Pubmed)
Abstract：
Surgery on head and neck masses presents unique challenges to overcome, especially in relation to preoperative anesthesia induction. Tumor proximity to the carotid sinus can result in extreme hemodynamic depression, by way of compression or direct invasion of the node. Neck hyperextension required for endotracheal intubation can worsen the underlying compression. Additionally, many anesthetic agents have sympatholytic properties that can exacerbate this imbalance further toward the parasympathetic response. We present a case of a patient with non-Hodgkin lymphoma whose tumor compression of the carotid sinus precipitated an exaggerated vagal reflex response following fentanyl administration.
摘要：
头颈部肿块的手术提出了需要克服的独特挑战，特别是关于术前麻醉诱导。肿瘤靠近颈动脉窦可导致极度的血流动力学抑制，通过压缩或直接侵入节点。气管内插管所需的颈部过度伸展会使潜在的压迫恶化。此外,许多麻醉剂具有交感神经溶解特性，可以进一步加剧这种不平衡向副交感神经反应。我们介绍了一例非霍奇金淋巴瘤患者，其颈动脉窦的肿瘤压迫导致芬太尼给药后迷走神经反射反应过度。
