陳旧性キニーネ網膜症患者の麻酔後一過性視力障害

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  • Postanesthetic Transient Blindness in a Patient with Old Retinal Quinine Toxicity.

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A 76-year-old female underwent cholecystectomy under general and epidural anesthesia. She complained of visual loss approximately 5 hours after the procedure. On the next day, bilateral central retinal artery occlusions were diagnosed by the ophthalmologist. Her visual disturbance improved after 3 days of medical treatment with dextran, urokinase and hydrocortisone.<br>Her past history revealed that the patient had taken a quinine derivative for fever when she was 32 years old and subsequently had suffered severe blindness. Her visual acuity later improved, but her sight still remained weak with optic disc pallor and retinal arterial attenuation as after-effects. We concluded that hyperventilation was the most likely cause of the decrease in occular blood flow during anesthesia and of thrombi in the lumen of the attenuated central retinal arteries. We are convinced knowledge of preoperative past history and cautious management in respiration are very important to prevent complications during surgery.

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