General Anesthesia for Cesarean Section in a Pregnant Woman with Truncus Arteriosus Intraoperatively Monitored by Transesophageal Echocardiography

Truncus arteriosus (TA) is defined as a congenital cardiovascular malformation in which one great artery arises from the base of the heart and gives origin to the pulmonary and systemic arteries. TA patients who become pregnant have high morbidity and mortality rates because physiologic changes during pregnancy can worsen the cardiopulmonary balance causing cardiopulmonary decompensation. In this case report we report a successful general anesthesia in a truncus arteriosus patient with severe pulmonary hypertension (Eisenmenger syndrome) who underwent a full-term pregnancy delivery monitored by intraoperative transesophageal echocardiography, a new technique to assist physicians in dealing with patients with hemodynamic instability during both cardiac and noncardiac surgery.

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Rigid Laryngoscope-assisted Insertion of Transesophageal Echocardiography Probe Reduces Oropharyngeal Mucosal Injury in Anesthetized Patients

Anesthesiology ◽

10.1097/aln.0b013e318190b56e ◽

2009 ◽

Vol 110 (1) ◽

pp. 38-40 ◽

Cited By ~ 30

Author(s):

SungWon Na ◽

Chang Seok Kim ◽

Ji Young Kim ◽

Jin Seon Cho ◽

Ki Jun Kim

Keyword(s):

General Anesthesia ◽

Transesophageal Echocardiography ◽

Cardiac Disease ◽

Mucosal Injury ◽

Conventional Group ◽

Hemodynamic Parameters ◽

Significant Difference ◽

Intraoperative Transesophageal Echocardiography

Background Intraoperative transesophageal echocardiography has become a routine part of monitoring in patients with cardiac disease. However, insertion of a transesophageal echocardiography probe can be associated with oropharyngeal, esophageal, and gastric injuries. The purpose of this study was to determine whether insertion of a transesophageal echocardiography probe under direct laryngoscopic visualization can reduce the incidence of oropharyngeal mucosal injury. Methods Eighty patients undergoing surgery with general anesthesia were randomly allocated to either the conventional group, in which the probe was inserted blindly, or the laryngoscope group, in which a rigid laryngoscope was used to visualize the passage of the probe. The incidence of oropharyngeal mucosal injury, the number of insertion attempts, and odynophagia were assessed. Results There was no significant difference in demographic and hemodynamic parameters between the 2 groups. The incidence of oropharyngeal mucosal injury was higher in the conventional group than in the laryngoscope group (55% vs. 5%, P < 0.05). The incidence of odynophagia was higher in the conventional group than in the laryngoscope group (32.5% vs. 2.5%, P < 0.05). The number of insertion attempts was also higher in the conventional group than in the laryngoscope group. Conclusion Rigid laryngoscope-assisted insertion of the transesophageal echocardiography probe reduces the incidence of oropharyngeal mucosal injury, odynophagia, and the number of insertion attempts.

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