Abstract
Ventricular septal perforation is use to be severe life threatening complication of myocardial infarction.
We experienced the anesthetic management for partial colectomy 80 year-old male, diagnosed as ventricular septal perforation combined with myocardial infarction.
Anesthesia was induced by fentanyl and thiamylal, and maintained by 0.2∼0.5% sevoflurane in 50% of nitrous oxide and oxygen, in addition to epidural anesthesia with 1.5% mepivacaine.
Epidural injection of 6ml of 1.5% mepivacaine decreased pulmonary arterial pressure, and epidural anesthesia was considered useful for reduction of pulmonary arterial pressure in this case.
During anesthesia, we used an echofiberscope for abdominal organ, to observe myocardial wall motion. Although this apparatus was for abdominal organ, it was useful to detect abnormalities of the wall motion during anesthesia.
The operation has been done uneventfully. The patient was stable postoperatively and discharged on the 16 post-operative day without any major complications.
