麻酔と蘇生 Volume 55 Issue 1
published_at 2019-03-01

抗生剤によるビタミンK欠乏性凝固異常のために硬膜外カテーテル抜去に難渋した3症例

Three Cases Becoming Difficult to Remove Epidural Catheter Postoperatively Due to Coagulation Defect Associated with Antibiotics
Hirata Yuri
Masuda Yoko
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AnesthResus_55-1_45.pdf
Abstract
Perioperative vitamin K deficiency can cause severe coagulopathy rapidly. Vitamin K deficiency tends to be overlooked despite the elucidation of pathophysiology and countermeasures. The main causes of vitamin K deficiency are insufficient intake, low supply from intestinal bacteria, and synthesis inhibition of vitamin K by N-methyltetrazolethiol (N - MTT) contained antibiotics. We experienced three cases in which it was difficult to remove epidural catheter because of coagulation abnormality due to vitamin K deficiency after surgery. Vitamin K deficiency should be wary of when epidural catheter is indwelled or withdrawn from a patient who is administered with antibiotic containing N-MTT in the fasted state.
Keywords
ビタミンK欠乏症
硬膜外麻酔
抗生剤
NMTT 基
PIVKA-II
vitamin K deficiency
epidural anesthesia
antibiotic
N-methyltetrazolethiol