Inoue Satoki, Furuya Hitoshi
Department of Anesthesiology, Nara Medical University, Kashihara Nara, Japan.
Acta Anaesthesiol Taiwan. 2006 Sep;44(3):187-9.
We report a safe anesthetic management of patients with multiple sclerosis (MS) using sevoflurane. A 34-yr-old female patient with a 2-yr history of MS was scheduled for gynecological surgery. Anesthesia was induced with propofol and fentanyl and maintained with sevoflurane, nitrous oxide, and fentanyl. Vecuronium was used for tracheal intubation. The patient showed rapid emergence from anesthesia. Exacerbation of symptoms of MS was negative according to the neurologic assessment at that time. Postoperative pain was managed mainly with continuous venous infusion of fentanyl instead of neural block with local anesthetics. Transient fever due to subcutaneous infection of the surgical site was observed and topical drainage was required. Eventually, postoperative exacerbation of symptoms of MS compared with preoperative status did not appear. In conclusion, sevoflurane does not induce exacerbation of symptoms and facilitates early postoperative neurologic assessment, therefore, it is one of ideal anesthetics for MS patients.
我们报告了使用七氟醚对多发性硬化症（MS）患者进行安全麻醉管理的情况。一名有2年MS病史的34岁女性患者计划进行妇科手术。麻醉诱导采用丙泊酚和芬太尼，维持采用七氟醚、氧化亚氮和芬太尼。维库溴铵用于气管插管。患者麻醉苏醒迅速。根据当时的神经学评估，MS症状加重为阴性。术后疼痛主要通过持续静脉输注芬太尼进行管理，而非使用局部麻醉剂进行神经阻滞。观察到手术部位皮下感染导致的短暂发热，需要进行局部引流。最终，与术前状态相比，术后MS症状并未加重。总之，七氟醚不会诱发症状加重，且有助于术后早期神经学评估，因此，它是MS患者理想的麻醉剂之一。
