Trikuspidalklappenersatz bei einer heroinabhängigen Patientin : Anästhesiologisches Management

A 24-year-old female with a history of former heroin addiction underwent open heart surgery for a mechanical tricuspid valve replacement. Anaesthesiological management included a thoracic epidural catheter at the Th 2 /Th 3 segments and balanced general anaesthesia (remifentanil, desflurane/propofol). Additionally, clonidine (2 μg*kg - 1 *h - 1 ) was continuously administered. Pain therapy was achieved using 0.375% ropivacaine via a thoracic epidural catheter (4 ml*h - 1 ) and metamizole (4x1 g/day) intravenously. With this concept we were able to achieve an appropriate anaesthesia and analgesia and the operation was carried out without complications.