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[General anesthesia for a patient with Noonan's syndrome and long-term antidepressant therapy].
- Source :
-
Masui. The Japanese journal of anesthesiology [Masui] 2005 Aug; Vol. 54 (8), pp. 901-3. - Publication Year :
- 2005
-
Abstract
- Noonan's syndrome is associated with cardiovascular, spinal and airway abnormalities. We experienced general anesthesia for a patient with Noonan's syndrome and long-term antidepressant therapy. A 42-year-old man was scheduled for radical operation for ventral hernia. He had been diagnosed as Noonan's syndrome by his facial and spinal abnormalities. He was intubated under bronchofiberscopy for his previous general anesthesia. He had received amitriptyline 50 mg daily for ten years. Anesthesia was induced with midazolam 3 mg, fentanyl 50 microg, droperidol 1.25 mg. He was intubated under bronchofiberscopy after topical lidocaine 400 mg application. Then thiopental 125 mg and sevoflurane 0.4% was administered. Blood pressure decreased after intubation to 70/40 mmHg, which was resistant to ephedrine 10 mg. After starting surgery, blood pressure increased to 100/70 mmHg and was stable until the end of surgery. This patient presented a problem of difficult intubation as Noonan's syndrome and had a history of a long-term use of antidepressant, which might induce sympathomimetic resistant hypotension.
- Subjects :
- Adult
Amitriptyline administration & dosage
Antidepressive Agents administration & dosage
Drug Resistance
Ephedrine therapeutic use
Hernia, Ventral complications
Hernia, Ventral surgery
Humans
Hypotension drug therapy
Hypotension etiology
Intraoperative Complications drug therapy
Intraoperative Complications etiology
Male
Sympathomimetics therapeutic use
Time Factors
Amitriptyline adverse effects
Anesthesia, General
Antidepressive Agents adverse effects
Intubation, Intratracheal
Noonan Syndrome complications
Subjects
Details
- Language :
- Japanese
- ISSN :
- 0021-4892
- Volume :
- 54
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Masui. The Japanese journal of anesthesiology
- Publication Type :
- Academic Journal
- Accession number :
- 16104546