Perioperative Management for Abdominal Surgery in Bilateral Diaphragmatic Paralysis: A Case Report and Literature Review. Issue 10 (15th November 2017)

• Record Type: Journal Article
• Authors: Mizubuti, Glenio B.; Wang, Louie; Ho, Anthony M.-H.; Tanzola, Robert C.; Leitch, Jordan
• Is Part Of: A & A case reports. Volume 9:Issue 10(2017:Nov. 15)
• Publication Date: 2017-11-15
• Subjects: Anesthesiology -- Periodicals; Anesthesia -- Periodicals; Anesthesiology; Analgesia; Anesthesiology; Periodicals; 617.9605
• DOI: 10.1213/XAA.0000000000000592
• Languages: English
• ISSNs: 2325-7237

Abstract

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.