心・血管疾患を合併したSeckel症候群患者の麻酔経験 A Case Report of Seckel Syndrome with Cardiovascular Dysfunction
We described a first case report of Seckel syndrome (bird-headed dwarfism) with cardiovascular dysfunction. A 20-year-old man affected with Seckel syndrome had congestive heart failure, thromboembolism in the femoral artery, thrombis in deep veins, hepatomegaly and renal dysfunction. He underwent a thrombectomy of the right femoral artery on an emergency basis under epidural anesthesia. An epidural catheter was inserted through the L3/4 intervertebral space, and a total dose of 1.5% mepivacaine 7 ml was injected into the epidural space. After 15 min, analgesia was obtained until the Th 8 level. When fentanyl 25, μg as a sedative was injected intravenously, severe bradycardia and hypotension occurred suddenly. After cardiac massage for a few seconds and injection of atropine, HR and BP were recovered immediately. After these treatments, hemodynamics were stable. It was considered that these events were due to the sudden pain relief and venous pooling produced by epidural blockade using local anesthetic, parasympathetic nerve activation caused by the use of fentanyl, and so on. Since Seckel syndrome may be associated with not only surface anomaly but also cardiovascular dysfunction, a close preoperative examination of cardiovascular system and strict anesthetic management are necessary.
- 日本臨床麻酔学会誌 = The Journal of Japan Society for Clinical Anesthesia
日本臨床麻酔学会誌 = The Journal of Japan Society for Clinical Anesthesia 19(2), 149-151, 1999-03-15
THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA