ABSTRACT
BACKGROUND: Perioperative venous thromboembolism (VTE) has been increasing in gynecologic and obstetric practice. Lower extremity venous ultrasound use in the detection of VTE has been studied and has proven both reliable and efficient. However, there have been very few reports of the preventive effect on VTE-related complication of preoperative lower limb venous ultrasonography in gynecologic and obstetric surgical cases. METHODS: Preoperative lower limb venous ultrasound imaging in gynecologic and obstetric surgical cases were performed to examine the presence or absence of deep vein thrombosis (DVT) and findings indicating the risk of DVT formation. RESULTS: Among 226 subjects, DVT and mural thrombus were observed in two and four subjects, respectively. Vasodilation within the soleus muscle was observed in the left leg in 10 subjects and the right leg in 15 subjects. Venous stasis was observed in 16 subjects. Fatal complications resulting from perioperative VTE could be avoided by preoperative thrombolytic therapy and prophylactic inferior vena cava filter placement based on preoperative screening. CONCLUSIONS: Our results suggest that preoperative lower limb venous ultrasonography was useful for the prevention of serious complications caused by perioperative VTE in gynecologic and obstetric surgical cases.
Subject(s)
Gynecologic Surgical Procedures , Lower Extremity/blood supply , Obstetric Surgical Procedures , Preoperative Care , Preoperative Period , Veins/diagnostic imaging , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/prevention & control , Adult , Aged , Female , Humans , Middle Aged , Perioperative Care , Pregnancy , Risk Factors , Thrombolytic Therapy , Ultrasonography , Vena Cava Filters , Young AdultABSTRACT
We experienced anesthetic management of a patient undergoing surgeries for bilateral femoral trochanter fractures before the onset and during the healing stages of takotsubo cardiomyopathy (TCM). While performing the surgery before the onset of TCM, we administered 0.5% intrathecal isobaric bupivacaine 15 mg and the procedure was completed uneventfully. On the other hand, while performing the surgery during the healing stages of TCM, vasopressor infusion was required for treating hypotension with extrasystoles despite administrating only 14.5 mg of 0.05% intrathecal isobaric bupivacaine. It is therefore suggested that cardiac function during the healing stages of TCM was more compromised than before the onset of the disease.