1. Perioperative Management for Abdominal Surgery in Bilateral Diaphragmatic Paralysis
- Author
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Louie Wang, Anthony M.-H. Ho, Robert Tanzola, Jordan K. Leitch, and Glenio B. Mizubuti
- Subjects
Anesthesia, Epidural ,medicine.medical_specialty ,medicine.drug_class ,medicine.medical_treatment ,Diaphragmatic paralysis ,Perioperative Care ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,030202 anesthesiology ,law ,Laparotomy ,medicine ,Humans ,Pain Management ,Hernia ,Herniorrhaphy ,Aged ,Local anesthetic ,business.industry ,030208 emergency & critical care medicine ,General Medicine ,medicine.disease ,Hernia repair ,Respiratory Paralysis ,Intensive care unit ,Hernia, Abdominal ,Surgery ,Analgesics, Opioid ,Opioid ,Anesthesia ,Administration, Intravenous ,Female ,business ,medicine.drug ,Abdominal surgery - Abstract
The optimal approach to postoperative analgesia in patients with bilateral diaphragmatic paralysis undergoing abdominal surgery remains unclear. We report a 69-year-old woman with bilateral diaphragmatic paralysis who underwent a laparoscopic hernia repair and an open laparotomy for reversal of a Hartmann procedure under general anesthesia. Postoperative analgesia was provided by intravenous opioid and epidural local anesthetic and opioid, respectively. The patient's trachea was successfully extubated at the end of both surgical procedures. Epidural analgesia was associated with better pain control and shorter intensive care unit stay.
- Published
- 2017
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