在肾上腺外嗜铬细胞瘤切除术中麻醉期间使用地氟烷：一例报告
Use of desflurane during anesthesia for resection of extra-adrenal pheochromocytoma: a case report.
作者信息
Oda Yutaka, Adachi Takahisa, Komatsu Ryushi, Shimada Motoko, Tanaka Yukio
机构信息
Department of Anesthesiology, Osaka City Juso Hospital, 2-12-27, Nonaka-kita, Yodogawa-ku, Osaka, 532-0034, Japan.
Department of Urology, Osaka City Juso Hospital, 2-12-27, Nonaka-kita, Yodogawa-ku, Osaka, 532-0034, Japan.
出版信息
JA Clin Rep. 2018 Oct 18;4(1):75. doi: 10.1186/s40981-018-0212-z.
BACKGROUND
Although various agents are used during anesthesia for surgical resection of pheochromocytoma, application of desflurane has rarely been reported. We report the use of desflurane in a case receiving resection of extra-adrenal pheochromocytoma.
CASE PRESENTATION
A 51-year-old female was transferred to our hospital for sustained hypertension. A diagnosis of extra-adrenal pheochromocytoma was made based on increased plasma catecholamine levels and radiographic findings. Surgical resection was planned after controlling blood pressure. General anesthesia was induced with propofol and fentanyl, followed by maintenance with desflurane 4.3% and remifentanil 0.2-0.4 μg/kg/min. Blood pressure and heart rate were stable during induction, tracheal intubation, and tumor manipulation. Blood pressure abruptly decreased to 62/40 mmHg after removal of the tumor, which was treated with noradrenaline. The surgery was completed uneventfully and the postoperative course was also uneventful.
CONCLUSION
Desflurane was safely used in combination with remifentanil during anesthesia for resection of extra-adrenal pheochromocytoma.
背景
尽管在嗜铬细胞瘤手术切除的麻醉过程中使用了多种药物，但地氟烷的应用报道很少。我们报告了1例肾上腺外嗜铬细胞瘤切除术患者使用地氟烷的情况。
病例介绍
一名51岁女性因持续性高血压转入我院。根据血浆儿茶酚胺水平升高和影像学检查结果，诊断为肾上腺外嗜铬细胞瘤。在控制血压后计划进行手术切除。采用丙泊酚和芬太尼诱导全身麻醉，随后用地氟烷4.3%和瑞芬太尼0.2 - 0.4μg/kg/min维持麻醉。诱导、气管插管和肿瘤操作期间血压和心率稳定。肿瘤切除后血压突然降至62/40 mmHg，使用去甲肾上腺素进行治疗。手术顺利完成，术后过程也无异常。
结论
在肾上腺外嗜铬细胞瘤切除术中，地氟烷与瑞芬太尼联合用于麻醉是安全的。
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