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Propofol Anesthesia for Cesarean Section Successfully Managed in a Patient with Moyamoya Disease
- Source :
- Journal of Clinical Anesthesia. 10:242-245
- Publication Year :
- 1998
- Publisher :
- Elsevier BV, 1998.
-
Abstract
- We report a case of general anesthesia in a 25-year-old female patient with moyamoya disease who presented for cesarean section. General anesthesia was induced with propofol 100 mg, succinylcholine 50 mg, and nicardipine 1 mg intravenously (IV), and maintained with 60% nitrous oxide in oxygen. Just after the clamp of the umbilical cord, propofol 10 mg/kg/hr following propofol 50 mg, pentazocine 15 mg, vecuronium 8 mg, and methylergometrine maleate 0.2 mg were given IV. The rate of infusion of propofol was reduced to 8 mg/kg/hr 10 minutes after the clamp and reduced to 6 mg/kg/hr 20 minutes after the clamp. Additional pentazocine 15 mg was given IV. Blood pressure was maintained between 110 and 145 systolic, and 50 and 85 diastolic mmHg, and end-tidal carbon dioxide was between 34 and 36 mmHg. No postoperative deterioration of the patient's neurologic findings occurred. For the anesthetic management of moyamoya disease patients, especially in delivery, it is important to avoid hemodynamic changes and to maintain cerebral blood flow (CBF). We used propofol for hemodynamic stability and avoided hyperventilation so as to maintain CBF. We successfully managed the patient perioperatively.
- Subjects :
- Adult
Pentazocine
medicine.medical_specialty
Vasodilator Agents
Nicardipine
Nitrous Oxide
Hemodynamics
Blood Pressure
Succinylcholine
Methylergonovine
Pregnancy
Oxytocics
Hyperventilation
Tidal Volume
medicine
Anesthesia, Obstetrical
Humans
Moyamoya disease
Propofol
Vecuronium Bromide
Cesarean Section
business.industry
Carbon Dioxide
medicine.disease
Surgery
Analgesics, Opioid
Pregnancy Complications
Anesthesiology and Pain Medicine
Blood pressure
Cerebral blood flow
Cerebrovascular Circulation
Neuromuscular Depolarizing Agents
Anesthesia
Anesthetics, Inhalation
Anesthesia, Intravenous
Analgesia, Obstetrical
Female
Moyamoya Disease
medicine.symptom
business
Anesthetics, Intravenous
Neuromuscular Nondepolarizing Agents
medicine.drug
Subjects
Details
- ISSN :
- 09528180
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Anesthesia
- Accession number :
- edsair.doi.dedup.....bfd87775e639c15018e4508001d1ac92
- Full Text :
- https://doi.org/10.1016/s0952-8180(98)00015-4