41. Gây mê mổ viêm ruột thừa cấp cho bệnh nhân có bệnh lý tim bẩm sinh chuyển gốc đại động mạch có sửa chữa bẩm sinh: Báo cáo một trường hợp lâm sàng

Abstract

Anesthesia for patients with complex congenital heart disease, especially congenitally corrected transposition of the great arteries for noncardiac surgery, always requires an anesthesiologist with a thorough understanding of anatomy, pathology as well as having a close collaboration with surgeons and cardiologists. Patients with this complex congenital heart disease pathology is one of the causes of increased perioperative morbidity and mortality, especially in emergency surgery patients. Before surgery, the patient should be monitored, optimized treatment, evaluated by the cardiologist, the anesthesiologist and the surgeon. During anesthesia and surgery, patients should be continuously monitored and avoid factors that aggravate the patient's clinical condition such as pulmonary hypertesion, hypoxemia, hypothermia, metabolic acidosis, transmission restriction. Postoperatively, the patient should received adequate analgesia, avoiding residual anesthetics, opioids and muscle relaxation. We report a case of a 16-year-old female, with a history of complex congenital heart disease; the patient had congenitally corrected transposition of the great arteries from 3 months of age, followed by a pulmonary valve stenosis, and had undergone an angioplasty; patient was admitted to the hospital for abdominal pain and was diagnosed with acute appendicitis; she subsequently received endotracheal anesthesia for laparoscopic appendectomy, and was discharged in stable condition after surgery.