Anesthetie Management for the Reconstructive Surgery of Renovascular Hypertension / 대한마취과학회지

ABSTRACT

It is very important for the anesthesiologists to manage this kind of patient during anesthesia because of severe hemodynamic change that is induced by aortic clamping and declamping, and its secondary effect on visce, heart and spinal cord, etc. To minimize the sudden severe hemodynamic change, we used the following agents and techniques in this clinical report. 1) Ethrane anesthesia with intermittent Innovar administration to minimize cardiac irritability. 2) To prevent secondary damage by distal hypotension during aortic clamping and declamping. 1. slight overhydration. 2. mannitol. 3. diuretics. 3) To prevent secondary damage by proximal hypertension during aortic clamping. 1. d-tubocurarine for muscle relaxation. 2. Morphine. 3. Chlorpromazine. 4. phentolamine. More over, we recommend this kind of anesthetic method in some other surgeries such as coarctation of aorta, aortic aneuryam and pheochromocytoma, etc. which may exhibit severe hemodynamic change during anesthesia.