Published online Sep 26, 2022. doi: 10.12998/wjcc.v10.i27.9859
Peer-review started: May 3, 2022
First decision: June 8, 2022
Revised: June 14, 2022
Accepted: August 21, 2022
Article in press: August 21, 2022
Published online: September 26, 2022
Processing time: 136 Days and 11.5 Hours
Eisenmenger syndrome (ES) is an uncorrected congenital cardiac defect with a left-to-right shunt, leading to pulmonary arterial hypertension. Patients with ES are susceptible to hemodynamic alterations during noncardiac surgery with general anesthesia, which increases perioperative morbidity and mortality. Monitored anesthesia care (MAC) is often used during minor procedures in patients with cardiac disease. However, few reports on MAC in patients with ES exist.
A 49-year-old man was admitted for a severe headache lasting 30 d. He had been diagnosed with a large perimembranous ventricular septal defect (VSD) with bidirectional shunt flow and pulmonary arterial hypertension 10 years ago. A round mass in the right frontal lobe was revealed by Magnetic resonance imaging. Stereotactic aspiration using a neuronavigation system was performed under MAC. The patient was stayed in the hospital for 5 d, and discharged without complications.
MAC may be effective for craniotomy in patients with ES.
Core Tip: Monitored anesthesia care (MAC) is often used during minor procedures in patients with cardiac disease. However, there are few reports on MAC in patients with Eisenmenger syndrome (ES). We report a case of MAC using dexmedetomidine and remifentanil for craniotomy in a patient with ES.