RESUMO
A 79-year-old man with aortic stenosis (AS) was scheduled for right middle lobectomy under general anesthesia. AS is a significant risk factor for the development of cardiac complications after noncardiac surgery. Anesthetic management adjusting left ventricular preload and coload, and keeping sinus rhythm was successful with no complications. But after moving back to the intensive care unit after surgery, ECG showed paroxysmal complete atrioventricular blocks and we inserted a temporary transvenous pacemaker catheter. We should be very careful with not only the anesthetic but also perioperative management of AS patient.
Assuntos
Estenose da Valva Aórtica/complicações , Estenose da Valva Aórtica/tratamento farmacológico , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/cirurgia , Idoso , Anestesia Geral , Humanos , Masculino , Assistência Perioperatória , Pneumonectomia , Fatores de RiscoRESUMO
We gave anesthesia for a patient with post-polio syndrome undergoing laparoscopic sigmoid colectomy. She is a 68-year-old woman and had been diagnosed as post-polio syndrome since she was 55 years of age. Before the operation, paralysis was observed in her right leg. After inducing anesthesia using propofol, muscle relaxation was obtained by rocuronium bromide for intubation. Remifentanil was used during the operation, and good pain relief was obtained by iv-PCA (fentanyl) after operation.
Assuntos
Anestesia Geral/métodos , Síndrome Pós-Poliomielite/complicações , Idoso , Feminino , Humanos , Neoplasias do Colo Sigmoide/cirurgiaRESUMO
We report a 61-year-old woman (weight 49 kg, height 156 cm) with Kugelberg-Welander disease who was scheduled for bilateral mastectomy under general anesthesia. We administered rocuronium 10 mg (0.20 mg x kg(-1)) for tracheal intubation. After 80 min, train-of-four ratio (TOFR) was 46%. During the operation, we did not administer rocuronium. After surgery, TOFR was 62%. Therefore, we administered sugammadex 100 mg (2 mg x kg(-1)). After 4 min, TOFR became above 90%, and the patient was extubated. There was no respiratory distress, muscle weakness, or neurologic untoward event after the use of sugammadex in the postoperative period. Sugammadex was effective in reversing rocuronium induced neuromuscular block in a patient with Kugelberg-Welander disease.