외상성 흉부대동맥류 재건술의 마취관리

The management of patient undergoing thoracic aortic surgical procedures represents a major challenge for the anesthesiologists. Aortic cross-clamping and unclamping are particularly hszardous during the- course of the thoracic aortic operation. Proximal hypertension, myocardial ischemia and arrhythmia have been reported to occur after application of the aortic cross-clampmg. Removal of the cross-clamp often results in severe hypotension with subsequent myocardial, cerebral and renal ischemia. In this case, the patient was managed successfully using Regitine drip during the cross-clamp and slow release of clamp during unclamp, combined with slight overhydration juat before unclamp.