Management of anesthesia in a patient with ruptured abdominal aortic aneurysm: A case report

AUTHORS

Mehrdad Malekshoar 1 , * , Hashem Jarineshin 1 , Saeid Kashani 1 , Seyed Mehdi Farsad 2 , Majid Vatankhah 1 , Ferydoun Fekrat 3

1 Assistant Professor Department of Anesthesiology, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

2 Assistant Professor Department of Surgury, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

3 Anesthesiologist, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

How to Cite: Malekshoar M, Jarineshin H, Kashani S, Farsad S M, Vatankhah M, et al. Management of anesthesia in a patient with ruptured abdominal aortic aneurysm: A case report, Hormozgan Med J. 2013 ; 17(2):e88111.

ARTICLE INFORMATION

Hormozgan Medical Journal: 17 (2); e88111
Published Online: February 19, 2013
Article Type: Case Report
Received: October 02, 2012
Accepted: February 19, 2013

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Abstract

Introduction: Abdominal aortic aneurysm is a multifactorial condition which associated
with aging and atherosclerosis. During aneurysm surgery, hypotension after aortic clamp
removing occure commonly that require specific treatments. This case report showes
administration of blood and hemodynamic control methods after aortic unclumping during
aortic aneurysm surgery.
Patient: A 75–years-old woman who complained of back and flank pain; initially
diagnosed and hospitalized as pyelonephritis. In ultrasound a pulsatile mass in middle part of
the abdomen and the abdominal aortic aneurysm was diagnosed for the patient. After
surgery consultation, the patient was diagnosed as ruptured abdominal aortic aneurysm.
Following removal of aortic clamp during surgery despite adequate volume administration
and reducing the maintenance dose of anesthetic agents, sever hypotension was occurred that
only by reclamping the aorta and its gradual opening effectively controlled in normal range.
Conclusion: With mixture of therapeutic measures such as intravascular ressusitation,
especially with hypertonic solution, we can applying the method of acute normovolemic
Hemodilutionthe. By using PEEP and monitoring ETco2, during the aortic clamping phase
and gradual opening of aortic clamp, we can anticipate and treat the hypotension after aortic
unclamping.

Keywords

Abdominal Aortic-Aneurism - Hemodynamic

© 2013, Hormozgan Medical Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

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