Anaesthetic Considerations in Patients of Takayasu Arteritis and Blunting of Stress Response to Intubation by Dexmedetomidine Infusion “A Report of two Cases”
Dr. Deepak Dwivedi,
Department of Anaesthesia and Critical Care, Institute of Naval Medicine, INHS Asvini,
Colaba, Mumbai-400005, Maharashtra, India.
Takayasu arteritis is an entity resulting in pan-endarteritis. It involves the principal arteries resulting in ischaemia and persistent hypertension. Hypertension affects the anaesthetic management where the principal goal is to control the haemodynamic stability during the induction and for the entire course of anaesthesia preventing damage to the end organs. We present two cases, one paediatric with hypertension refractory to medical management posted for nephrectomy and one adult patient posted for diagnostic hysterolaparoscopy. Both the cases were administered dexmedetomidine, an alpha 2 agonist during the pre-induction period. Sympatholysis caused by infusion dexmedetomidine was effectively utilized in both the cases hence, pre-induction infusion of dexmedetomidine can be utilized to obtund the haemodynamic response to intubation.