심실중격결손증으로 인한 Eisenmenger씨 증후군 환자의 마취관리 - 증례 보고

Eisenmenger's syndrome includes any condition in which communication between the pulmonary and systemic circulations gives rise to pulmonary vascular disease causing a right to left shunt with peripheral cynosis. The theoretical risks of anesthesia in patients with Eisenmenger's syndrome are considerable. We report on the case of a 47-year-old female patient with Eisenmenger's syndrome secondary to ventricular septal defect for transabdominal hysterectomy. Of prime concern was the maintenance of sytemic vascular resistance, and this was achieved using an infusion of phenylephrine started before the induction of anesthesia; the infusion continued after the operation. We carefully performed general anesthesia with N2O-O2-ketamine-fetanyl-enflurane. The patient was discharged for home 8 days later without complications. (Korean J Anesthesiol 1999; 37: 715∼720)