Wada Rina, Hino Hirofumi, Ando Yumi, Tateda Takeshi
Department of Anesthesiology, St. Marianna University School of Medicine, Kawasaki, Japan.
Masui. 2008 Feb;57(2):200-2.
We report management of anesthesia in a patient suffering from glucose-6-phosphate dehydrogenase (G6PD) deficiency, a condition that induces acute hemolysis when associated with surgical stress and infection, or following the application of oxidant drugs. A 5 year-old-male patient, suffering from G6PD deficiency was scheduled for laparoscopic cholecystectomy. The patient had exhibited signs of hemolysis during the course of various infections and after ingesting fava beans (favism). Anesthesia was induced with midazolam and vecuronium and maintained with nitrous oxide in oxygen and sevoflurane. There was no hemolytic change during the perioperative period. It was clear that this combination of drugs provided safe anesthesia for the G6PD patient in the present study. The most important considerations for patients with G6PD deficiency is firstly, the avoidance of oxidative stress, which can be caused by a variety of different conditions, and secondly, the use of anti-oxidative anesthetic drugs.
我们报告了一名葡萄糖-6-磷酸脱氢酶（G6PD）缺乏症患者的麻醉管理情况。这种疾病在与手术应激和感染相关时，或在使用氧化药物后会引发急性溶血。一名5岁男性患者，患有G6PD缺乏症，计划进行腹腔镜胆囊切除术。该患者在各种感染过程中以及食用蚕豆（蚕豆病）后出现了溶血迹象。麻醉诱导使用咪达唑仑和维库溴铵，维持使用氧化亚氮-氧气混合气体和七氟醚。围手术期未出现溶血变化。在本研究中，这种药物组合显然为G6PD缺乏症患者提供了安全的麻醉。对于G6PD缺乏症患者，最重要的考虑因素首先是避免氧化应激，这可能由多种不同情况引起；其次是使用抗氧化麻醉药物。
