Oyaizu Tomoko, Kikuchi Aya, Minoshima Rie, Nagata Hiromasa, Sakurai Hironori, Suzuki Takeshi, Katori Nobuyuki, Morisaki Hiroshi
Masui. 2014 Jul;63(7):820-2.
C1 inhibitor (INH) deficiency is characterized by the presence of angioedema of the extremities, face, airway and the gastrointestinal tract. Airway obstruction is the most common cause of mortality. A 78-year-old woman presented with repeated episodes of angioedema. These episodes were triggered by general anesthesia, dental extraction, venipuncture, vaccination and loxoprofen. The familiy history of similar symptoms was negative. C1 inhibitor concentrate was administered perioperatively for prophylaxis of attacks. Operation was performed under neurolept anesthesia and combined spinal-epidural anesthesia in order to avoid airway manipulation. Postoperative pain was controlled by patient-controlled epidural anesthesia to prevent attacks triggered by pain. The patient had angioedema on both lower extremities perioperatively but did not develop further attacks. Anesthesia was safely performed in a patient with C1 inhibitor deficiency scheduled for total hip arthroplasty.
C1 抑制剂（INH）缺乏症的特征是四肢、面部、气道和胃肠道出现血管性水肿。气道阻塞是最常见的死亡原因。一名 78 岁女性反复出现血管性水肿发作。这些发作由全身麻醉、拔牙、静脉穿刺、疫苗接种和洛索洛芬引发。类似症状的家族史为阴性。围手术期给予 C1 抑制剂浓缩物以预防发作。为避免气道操作，在神经安定麻醉和腰麻 - 硬膜外联合麻醉下进行手术。术后疼痛通过患者自控硬膜外麻醉控制，以防止疼痛引发发作。患者围手术期双下肢出现血管性水肿，但未进一步发作。为计划进行全髋关节置换术的 C1 抑制剂缺乏症患者安全实施了麻醉。
