Transesophageal echocardiography
Anesthesia type |
MAC |
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Airway |
Natural airway |
Lines and access |
1 PIV |
Monitors |
Standard ASA |
Primary anesthetic considerations | |
Preoperative | |
Intraoperative | |
Postoperative | |
Article quality | |
Editor rating | |
User likes | 0 |
Transesophageal echocardiography (TEE) is a specialized probe with an ultrasound transducer that is inserted into the esophagus and pointed anteriorly to capture images of the heart. It can be done as a standalone procedure, but is also used routinely in cardiac surgeries.
Overview
Indications
Surgical procedure
Preoperative management
Patient evaluation
System | Considerations |
---|---|
Airway | |
Neurologic | |
Cardiovascular | |
Pulmonary | |
Gastrointestinal | |
Hematologic | |
Renal | |
Endocrine | |
Other |
Labs and studies
Operating room setup
Patient preparation and premedication
Lidocaine 4% spray into back of oropharynx. Ask patient to gargle for 10 seconds.
Regional and neuraxial techniques
Intraoperative management
Monitoring and access
Induction and airway management
Because patients requiring TEE typically have poor cardiac function, hemodynamically stable cardiac induction is preferred. This can be achieved with small amounts of propofol, midazolam, and fentanyl. That said, midazolam (0.5-1 mg) followed by ketamine (20-30 mg) is a very popular induction of choice in patients with critically low EF and tenuous respiratory status to avoid afterload reduction and to avoid hypoventilation worsening right heart function.
Positioning
Supine with head at 30 degrees, slight tilt to left.
Bite block is placed for TEE probe.
Maintenance and surgical considerations
Insertion of TEE probe is facilitated with jaw thrust. This is the most stimulating part of procedure by far. Minimal anesthesia is generally required for maintenance.
Emergence
Postoperative management
Disposition
PACU
Pain management
Potential complications
Procedure variants
Variant 1 | Variant 2 | |
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Unique considerations | ||
Position | ||
Surgical time | ||
EBL | ||
Postoperative disposition | ||
Pain management | ||
Potential complications |
References
Top contributors: Tony Wang and Chris Rishel