Terada Y, Furuya A, Ishiyama T, Matsukawa T, Kumazawa T
Department of Anesthesiology, Yamanashi Medical University, Yamanashi 409-3898.
Masui. 2001 Jul;50(7):789-91.
Congenital sensory neuropathy with anhydrosis is a rare disorder characterized by insensitivity to pain with normal tactile perception, self-mutilation, anhydrosis, recurrent unexplained fever, mental retardation and variable autonomic abnormality. We managed a 14-year-old boy with this syndrome who underwent repair of right femur fracture. Anesthesia was induced with propofol and ketamine. Adequate depth of anesthesia was carefully controlled by processed electroencephalogram, and core body temperature was maintained at 37.0 degrees C during the surgery. The patient was well sedated, and nausea and vomiting were not noted postoperatively. Use of droperidol and propofol may be beneficial for anesthetic management of this syndrome, because droperidol exerts residual hypnotic effect postoperatively, and both drugs have antiemetic property.
先天性无汗性感觉神经病是一种罕见的疾病,其特征为对疼痛不敏感但触觉正常、自残行为、无汗、反复不明原因发热、智力迟钝以及自主神经功能异常。我们治疗了一名患有该综合征的14岁男孩,他接受了右股骨骨折修复手术。采用丙泊酚和氯胺酮诱导麻醉。通过处理后的脑电图仔细控制麻醉的适当深度,手术期间核心体温维持在37.0摄氏度。患者镇静良好,术后未出现恶心和呕吐。使用氟哌利多和丙泊酚可能有助于该综合征的麻醉管理,因为氟哌利多术后有残留催眠作用,且两种药物都有止吐特性。