RESUMEN
A 75-year-old woman was scheduled for the right partial pulmonary resection, because of severe hypoxemia caused by monofocal arteriovenous malformation. Before the operation, we obstructed successfully the shunt flow of arteriovenous malformation by using a balloon of pulmonary artery catheter. The hypoxemia was improved remarkably and we could control anesthesia safely.
Asunto(s)
Anestesia , Malformaciones Arteriovenosas/cirugía , Cateterismo/métodos , Atención Perioperativa , Arteria Pulmonar/anomalías , Venas Pulmonares/anomalías , Anciano , Malformaciones Arteriovenosas/complicaciones , Femenino , Humanos , Hipoxia/etiología , Hipoxia/terapia , Pulmón/cirugía , Neumonectomía , Resultado del TratamientoRESUMEN
A 61-year-old man showed clinical findings which suggest atypical malignant hyperthermia after pancreatoduodenectomy. He showed no abnormal findings in preoperative examinations. General anesthesia was induced with thiopental, fentanyl, and vecuronium, and epidural anesthesia was also used for the perioperative management. The surgery went on uneventfully and the patient returned to the ward. The laboratory data after the surgery showed extremely high creatine kinase and myoglobin. The patient's body temperature rose up and showed rigidity. We suspected atypical malignant hyperthermia and began its treatment. Four months later, we performed muscle biopsy and Ca-induced Ca release (CICR) test, which presented a typical rising pattern. This is the first case of malignant hyperthermia which occurred after the surgery and accompanied by a typical rise in CICR.
