A case report of anesthetic management of the minimally invasive Nuss operation for pectus excavatum.

Abstract:

:We describe the anesthetic management of a patient with pectus excavatum, receiving the minimally invasive Nuss operation, which corrects chest wall deformity by insertion of a convex steel bar (pectus bar). An 8-year-old female patient was scheduled for the Nuss operation. The manipulation of the bar in the thorax was guided by thoracic endoscopy. Anesthesia was maintained with a combination of general and epidural anesthesia. The intraarterial catheter and epidural catheter were inserted after the induction of general anesthesia. During the manipulation of the pectus bar in the anterior mediastinum, a sudden decrease in arterial pressure might occur due to the compression of the heart. Therefore, the intraarterial line was essential for continuous monitoring of arterial pressure. The pectus bar causes severe postoperative pain, and the patient was required to remain at bed rest for several days. Continuous epidural infusion of ropivacaine and morphine eliminated the postoperative pain and enabled the patient to maintain bed rest. For the anesthetic managements of patients undergoing the Nuss operation, close monitoring of arterial pressure intraoperatively and postoperative analgesia are important.

journal_name

J Anesth

journal_title

Journal of anesthesia

authors

Ichizawa M,Morimura E,Tsuchiya N,Hanafusa T,Shinomura T

doi

10.1007/s00540-004-0269-x

subject

Has Abstract

pub_date

2005-01-01 00:00:00

pages

73-4

issue

1

eissn

0913-8668

issn

1438-8359

journal_volume

19

pub_type

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