| A Laparoscopic Cholecystectomy in a Patient with Aortic Dissection. |
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Bong Il Kim, Jin Yong Chung, Hee O Kim |
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Department of Anesthesiology, School of Medicine, Catholic University of Daegu, Daegu, Korea. bikim@cataegu.ac.kr |
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| Abstract |
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We experienced a case of a laparoscopic cholecystectomy in a 64 year old woman with DeBakey type IIIb, Daily type B abdominal aortic dissection diagnosed at the emergency room.
Isosorbide dinitrate and propranolol were given for control of blood pressure preoperatively. Fentanyl, propofol, atracurium, lidocaine, esmolol and isoflurane were used for smooth induction, and isoflurane in a mixture of O2, N2O (1:1) were inhaled for maintenance. Intraabdominal pressure for pneumoperitonium was kept to 10 mmHg which was lower than that of usual use. An A-line, ETCO2, pulse oximeter and thoracic bioimpedance were monitored. The patient was anesthetized safely and discharged 3 days after the operation. The hemodynamic changes during pneumoperitonium and it's correlation with aortic dissection are discussed. |
| Key Words:
Aortic dissection; hemodynamics; laparoscopic cholecystectomy |
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