無脾症候群患者の全身麻酔経験

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  • General Anesthesia for a Patient with Asplenia Syndrome

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Asplenia syndrome is a rare congenital abnormality with multiple organ malposition and various cardio-vascular deformity. We experienced a case of Asplenia syndrome with endo-cardial cushion defect, double outlet right ventricle and total anomalous pulmonary venous drainage. The patient was a 4-year-old female who required general anesthesia for dental treatment. Diagnosis of Asplenia was made at her early neonate and Fontan operation was performed at 2 years and 10 months old. Pulseoximeter showed 89 to 90% of oxihemoglobin under room air respiration, but no clubbed finger nor cyanosis were appeared as a present state. After the establishment of a venous route, anesthesia was induced with flunitrazepam (0.4 mg) and fentanyl (75 μg), and orotracheal intubation was done after facilitated with vecuronium bromide (1.6 mg). Anesthesia was maintained with the continuous infusion of fentanyl (3μg/kg/hr) and intermitted supplementation with flunitrazepam and vecu-ronium bromide. The patient was ventilated with oxygen (1.5l/min) and air (4.5l/min). Dental caries treatment for 14 teeth (11 composite resin filling and 3 prosthese after pulpectomy) was performed. The course of anesthesia during 4 hours and 10 minutes was uneventful, and also the post operative course was satisfied with sedation.

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  • 松本歯学

    松本歯学 28 (2), 70-74, 2002-08-31

    松本歯科大学学会

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