Anesthesia for Surgical Fixation of the Fractured Neck of Femur in a Patient with Eisenmenger's Syndrome : A case report

Kim, Eun Sung; Hong, Sang Hyun; Lee, Yoon Ki; Ryu, Keon Hee; Yoo, Yung Joon

Case Report

Cardiothoracic and Vascular Anesthesia

Anesthesia and Pain Medicine 2008;3(1):40-43.
Published online January 30, 2008.

Anesthesia for Surgical Fixation of the Fractured Neck of Femur in a Patient with Eisenmenger's Syndrome : A case report

Eun Sung Kim, Sang Hyun Hong, Yoon Ki Lee, Keon Hee Ryu, Yung Joon Yoo

Department of Anesthesiology and Pain Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea. lifesucks@catholic.ac.kr

Abstract

Eisenmenger's syndrome consists of high pulmonary vascular resistance with reversed or bidirectional shunt at aortopulmonary, ventricular, or atrial level. Noncardiac surgery for a patient with this syndrome is challenging because both the perioperative morbidity and mortality are high. We describe the anesthetic management of a 66-year-old female patient with Eisenmenger's syndrome secondary to the tetralogy of Fallot (TOF), who was operated on for the fractured neck of her left femur. Anesthesia was induced with etomidate and sufentanil and was maintained with propofol and sufentanil without any inhalational anesthetics (total intravenous anesthesia). To maintain the systemic vascular resistance, we administered norepinephrine throughout the surgery and the postoperative care. The patient was discharged 20 days after the operation without any complications.

Key Words: Eisenmenger's syndrome, norepinephrine, total intravenous anesthesia