RESUMEN
Little information is available regarding the sensitivity to neuromuscular blocking drugs in patients with spinocerebellar degeneration and associated diseases. We report the response to vecuronium in a patient with late cerebellar cortical atrophy, a nonhereditary type of cerebellar ataxia. Onset time and time to 25% recovery of T1/T0 after vecuronium 0.1 mg.kg(-1) under sevoflurane anesthesia were 156 seconds and 43 minutes, respectively. Recovery index was 27 minutes. We believe this is the first report describing a response to neuromuscular blocking drugs in this disease.
Asunto(s)
Corteza Cerebelosa/patología , Fármacos Neuromusculares no Despolarizantes , Degeneraciones Espinocerebelosas/fisiopatología , Bromuro de Vecuronio , Anciano , Anestesia General , Anestésicos por Inhalación , Atrofia , Humanos , Neoplasias Pulmonares/cirugía , Masculino , Éteres Metílicos , Monitoreo Intraoperatorio , Sevoflurano , Degeneraciones Espinocerebelosas/complicaciones , Degeneraciones Espinocerebelosas/patología , Transmisión Sináptica/efectos de los fármacosRESUMEN
We experienced perioperative management of a patient with schizophrenia who had been taking a large amount of antipsychotic agents until the cesarean section. A 31-year-old woman in 38th week gestation with schizophrenia underwent a cesarean section. Anesthesia was maintained with light plane of general anesthesia combined with epidural anesthesia. Perioperatively, the mother experienced no complications and the baby only developed slight generalized tremor and hypotonus for a short period after delivery.
Asunto(s)
Anestesia Obstétrica/métodos , Antipsicóticos/uso terapéutico , Cesárea , Esquizofrenia/tratamiento farmacológico , Adulto , Anestesia Epidural , Femenino , Humanos , EmbarazoRESUMEN
We report severe hypotension after induction of general anesthesia in a patient receiving an angiotensin II receptor antagonist and an alpha-blocker. A 50-year-old man with diabetes mellitus who had been treated with candesartan cilexetil and doxazosin was scheduled for vitreous surgery. He was operated on for vitreous surgery three times. He developed severe hypotension after induction of anesthesia with propofol and fentanyl on two occasions, when he was taking candesartan cilexetil and doxazosin. Repeated injections of intravenous ephedrine could not raise the blood pressure. After discontinuation of both drugs, although he developed hypotension after induction of anesthesia with propofol and fentanyl, hypotension was mild and responded promptly to intravenous ephedrine.