Perioperative anesthesia management progress on aortic stenosis patients undergoing non-cardiac surgery / 临床麻醉学杂志

Aortic stenosis is a valvular heart disease(VHD)mainly caused by rheumatic fever se-quelae,congenital aortic valve structural abnormalities,senile aortic valve calcification,and so on,among which calcific aortic stenosis is the chief form of aortic stenosis.Echocardiography is often used technique to evaluate and diagnose aortic stenosis in the world,the normal adults aortic valve area(AVA)≥3.0 cm2,when AVA decreases to 1/3 or more of the normal,the aortic valve forward flow will be blocked,most mild to moderate and some severe aortic stenosis patients have no clinical symptoms during daily activities.The epidemiology of aortic stenosis varies greatly in different regions,ages,genders,and races.Aortic stenosis increases the risk of perioperative cardiovascular complications in non cardiac surgery,the risk depends on VHD severity and non cardiac surgery type,the perioperative mortality of untreated severe aortic stenosis pa-tients undergoing non cardiac surgery is high.This review describes the recent progress in the diagnosis,classification,pathological mechanism,treatment and perioperative anesthesia management of aortic stenosis undergoing non-cardiac surgery.

Application of ultrasound-guided ilioinguinal/iliohypogastric nerve blocks marked by arteriae circumflexa ilium profundain elderly hernia surgery / 临床麻醉学杂志

Objective To explore the clinical effect of ultrasound-guided ilioinguinal/iliohypo-gastric nerve blocks marked by arteriae circumflexa ilium profunda in elderly hernia surgery. Methods Forty ASA Ⅰ-Ⅲ grade patients (33 males and 7 females)of 65-90 years old scheduled for elective hernia surgery were randomly divided into two groups (n =20).In group T,patients received ilioinguinal/iliohypogastric nerve blocks bytraditional anatomical positioning;in group V,patients re-ceived ultrasound-guided ilioinguinal/iliohypogastric nerve blocks marked by arteriae circumflexa ilium profunda.The comparison was made between the two groups in term of onset time of anesthe-sia,VAS score of intraoperative and postoperative 6 h.Anesthesia satisfaction,incidence of uros-chesis,misplacement local anesthetics into blood-vessels were recorded.Results The onset time of anesthesia in group V was significantly shorter than that in group T [(6.1 ± 1.8)min vs (12.1 ± 2.0)min,P <0.05].The VAS score of intraoperative in group T was significantly higher than that of group V [(4.5 ± 1.1 )scores vs (2.1 ± 0.9 )scores,P < 0.05 ].The anesthesia satisfaction of group V was higher than that of group T (P <0.05).There was one misplacement local anesthetics into blood-vessels in group T.Conclusion Ultrasound-guided ilioinguinal/iliohypogastric nerve blocks marked by arteriae circumflexa ilium profunda can provide safe,effective and reliable anesthesia in elderly hernia surgery.