大動脈弁狭窄症と房室伝導障害を合併した高度頸動脈狭窄症患者に対して中間頸神経叢ブロックと監視下麻酔管理で頸動脈内膜剝離術を施行した1症例

Local Anesthesia and Monitored Anesthesia Care for a Patient with Comorbidities

要旨

　わが国において頸動脈内膜剝離は一般的に全身麻酔で行われ，局所麻酔の報告はきわめて少ない。今回われわれは高度房室伝導障害と大動脈弁狭窄症を合併した症例に対して頸神経叢ブロックと監視下麻酔管理を用いて安定した血行動態で合併症なく管理できた症例を経験したので報告する。

　In Japan, a carotid endarterectomy is generally performed with the patient under general anesthesia, and there have been very few reports of the use of local anesthesia for this surgical procedure. We report a case in which local anesthesia was used for a patient with severe atrioventricular conduction disorder and aortic valve stenosis. The 82-year-old male patient was managed with stable hemodynamics and experienced no complications after the applications of a cervical plexus block and monitored anesthesia management. We believe that local anesthesia and monitored anesthesia care are effective methods for avoiding the use of general anesthesia in patients with comorbidities.