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Revista Española de Anestesiología y Reanimación (English Edition)
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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Anaesthetic management in neurosurgery in a patient with Eisenmenger syndrome an...
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Vol. 69. Issue 2.
Pages 109-113 (February 2022)
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Vol. 69. Issue 2.
Pages 109-113 (February 2022)
Case report
Anaesthetic management in neurosurgery in a patient with Eisenmenger syndrome and Down syndrome. A case report
Manejo anestésico en neurocirugía de paciente con síndrome de Eisenmenger y síndrome de Down. Reporte de un caso
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J.M. Gómez Tarradasa,
Corresponding author
jgomezt@clinic.ub.es

Corresponding author.
, A. Calvoa, I. Beldaa, T. Topczewskib, F.J. Terceroa, R. Valeroa
a Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Clínic de Barcelona, Barcelona, Spain
b Servicio de Neurocirugía, Hospital Clínic de Barcelona, Barcelona, Spain
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Abstract

Adults patients with congenital heart disease increasingly present for non cardiac surgery. The anesthetic management this type of patients in neurosurgery requires a meticulous surgical anesthetic planning. The need for urgent intervention, with the presence of a congenital heart disease evolved to Eisenmenger syndrome, associated to a difficult airway, is a challenge for the anesthesiologist. The use of dexmedetomidine may be a valid alternative. We present the case of a patient with Down syndrome, and Eisenmenger syndrome who underwent drainage of brain abscess from the emergency department and was subsequently scheduled for reintervention. We compare the different anesthetic techniques used in both procedures, analyzing the implications they had on the main physiopathological alterations presented by the patient.

Keywords:
Anesthesia
Neurosurgery
Dexmedetomidine
Down syndrome
Eisenmenger Complex
Pain
Analgesia
Anesthesia intravenous
Anesthesia general
Perioperative care
Intraoperative care
Emergency
Resumen

El número de pacientes con patología cardíaca congénita que se intervienen de cirugía no cardíaca está en aumento. El manejo de este tipo de pacientes en neurocirugía requiere de una planificación anestésico-quirúrgica minuciosa. La necesidad de intervención urgente junto con la presencia de una cardiopatía congénita evolucionada a síndrome de Eisenmenger, asociadas a una vía aérea difícil, van a suponer un reto para el anestesiólogo. La utilización de dexmedetomidina puede ser una alternativa. Presentamos el caso de una paciente con síndrome de Down y síndrome de Eisenmenger que fue sometida a un drenaje de absceso cerebral de urgencias siendo posteriormente reintervenida de forma programada. Se comparan las diferentes técnicas anestésicas empleadas en ambos procedimientos, analizando las implicaciones que tuvieron sobre las principales alteraciones fisiopatológicas que presentaba la paciente.

Palabras clave:
Anestesia
Neurocirugía
Dexmedetomidina
Síndrome de Down
Síndrome de Eisenmenger
Dolor
Analgesia
Anestesia intravenosa
Anestesia general
Cuidados perioperatorios
Cuidados intraoperatorios
Emergencias

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