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The anesthetic management of a patient with HOCM is described.
In HOCM, the characteristic abnormality of hemodynamics is a subaortic stenosis to left ventricular ejection. So, light anesthesia resulting in tachycardia and increased cardiac contractility is undesirable.
In anesthesia in the patient with HOCM, it is thought that narcotic and cardiodeprssant agent like enflurane or halothane are useful.
In this patient, propranolol, CoEQ and calcium antagonist were given until the day before the operation.
After premedication with diazepam and pentazocine, induction of anesthesia was with thiamylal and halothane, and maintenance was with nitrous oxide, halothane and morphine.
During maintenance, tachycardia was treated by propranolol and, phenylephrine was administered for hypotension.
In general, couse of anesthesia was uneventful.
