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척추후측만곡환자의 마취관리

Anesthetic Management of Kyphoscoliotic Patients

대한마취과학회지 1976년 9권 1호 p.71 ~ 74
박철주, 전세웅,
소속 상세정보
박철주 (  ) - 가톨릭대학의학부 마취과교실
전세웅 (  ) - 가톨릭대학의학부 마취과교실

Abstract


Cardiopulmonary dysfunction in deformity of the spine had been recognized and complicated with surgical risk. The deformity of the bony thoracic cage reduces it´s capacity and also impairs the action of the inspiratory muscles will increase work of breathing. Progression of the deformity, the work of breathing and arterial desaturation were further increased.
Primary alveolar hypoventilation will produce hypoxemia and resulting in polycythemia and increased pulmonary vascular resistance, and causes pulmonary hypertension and congestive heart failure.
The end result is similar to the cardiopulmonary failure of primary alveolar hypoventilation and of chronic obstructive bronchitis.
Two cases of severe kyphoscoliosis were anesthetised for appendectomy and caesarean section.
Anesthetic management of the severe kyphoscoliosis should be focused on the cardiopulmonary dysfunction.
In this respect, for the surgical patient with kyphoscoliosis, it is very important to detect the reduced cardiopulmonary function and to consider the prevention or treatment of postoperative pulmonary complication by use an antibiotics, IPPB with oxygen, tracheobronchial toilet, venesection, digitalization and diuretics.

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