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ID 47563
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別タイトル
A Case of a Combination of Wearing-Off-Like Symptoms and Autonomic Hyperreflexia Following Spinal Anesthesia for a Patient with Parkinson’s Disease Who is Treated by Deep Brain Stimulation
著者
田嶋 実
柳谷 忠雄
松浪 勝昭
近藤 洋司
笹田 将吾
彌久末 智子
永島 健太
キーワード
パーキンソン病
脳深部刺激療法
脊髄幹麻酔
合併症
Parkinson’s disease
Deep brain stimulation
neuraxial analgesia
complications
NDC
医学
抄録(英)
Deep brain stimulator (DBS) has been widely performed for various medically refractory movement disorders. We report a 70’s male patients with Parkinson’s disease (PD) treated by DBS in addition to anti-parkinsonian drugs who underwent transurethral lithotomy under spinal anesthesia twice. We canceled his usual medications for PD, therefore, his blood pressure was higher than usual. His DBS was turned off in the operation room before induction of anesthesia. Both anesthesia techniques for TUL surgeries were completed by spinal anesthesia used by 0.5% hyperbaric bupivacine. Immediately after spinal anesthesia in both surgeries, severe rigidity, airway obstruction and conscious change emerged. These complications were suspected wearing-off-likes symptoms of PD, which were proved because of spinal anesthesia itself and/or DBS off effects. Autonomic hyperreflexia with severe hypertension, abnormal sweating and excessive oral secretion was gradually appeared after infusion of normal saline to obtain surgical fields of view, however, these symptoms disappeared after the end of infusion. It was suspected that the adverse events were due to low effects of spinal anesthesia on autonomic nervous system degenerated by Parkinson’s disease. We turned on DBS immediately after the completion of surgeries, and resumed his oral medications on the next day of surgeries. There were no events in his courses. As there is little information and no standard anesthetic guidelines available on patients with DBS implant who are present for surgery, a careful management is needed to avoid complications.
内容記述
本稿の要旨は日本麻酔科学会 中国・四国支部第55回学術集会(松山市,2018年)で発表した。
掲載誌名
麻酔と蘇生
55巻
1号
開始ページ
39
終了ページ
43
出版年月日
2019-03-01
出版者
広島麻酔医学会
ISSN
0385-1664
NCID
言語
日本語
NII資源タイプ
学術雑誌論文
広大資料タイプ
学術雑誌論文
DCMIタイプ
text
フォーマット
application/pdf
著者版フラグ
publisher
部局名
医歯薬保健学研究科
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