Division of Anesthesiology, Department of Anesthesiology, Nihon University School of Medicine, Tokyo, Japan.
Division of Neurosurgery, Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan.
Adv Exp Med Biol. 2024;1463:51-55. doi: 10.1007/978-3-031-67458-7_9.
A safe induction method of general anaesthesia for paediatric moyamoya disease patients has not been fully established. We had the opportunity to administer general anaesthesia twice to a two-year-old girl diagnosed with moyamoya disease. We used different induction methods for general anaesthesia at each session, i.e. slow induction with sevoflurane and rapid induction with propofol, and were able to evaluate changes in her left regional cortical blood volume (rCBV) and oxygenation (rCBO) during both anaesthesia inductions using near-infrared spectroscopy (NIRS). The mean change value of total-Hb (rCBV) (mean ± SD; μmol/L) in the rapid induction was lower than that in the slow induction (-0.54 ± 1.43 vs. 1.82 ± 1.74). However, the TOI (rCBO) levels during both anaesthesia inductions were constantly higher than these respective baseline values (64% in the slow induction, 71% in the rapid induction), and these mean change values in each of the anaesthesia induction were about the same. The present results suggested that both the slow induction method with sevoflurane and the rapid induction method with propofol might be safe and effective for anaesthesia induction in paediatric patients with moyamoya disease.
尚未完全确立用于小儿烟雾病患者全身麻醉的安全诱导方法。我们有机会对两名被诊断为烟雾病的两岁女孩进行了两次全身麻醉。我们在每次全身麻醉中使用了不同的诱导方法，即七氟醚缓慢诱导和异丙酚快速诱导，并能够使用近红外光谱（NIRS）评估两次麻醉诱导过程中她的左侧区域皮质血容量（rCBV）和氧合（rCBO）的变化。快速诱导的总-Hb（rCBV）（平均值±标准差；μmol/L）的平均变化值低于缓慢诱导（-0.54±1.43 vs. 1.82±1.74）。然而，在两次麻醉诱导期间，TOI（rCBO）水平始终高于各自的基础值（缓慢诱导为 64%，快速诱导为 71%），并且每个麻醉诱导的这些平均变化值大致相同。目前的结果表明，七氟醚缓慢诱导法和异丙酚快速诱导法都可能是小儿烟雾病患者麻醉诱导的安全有效方法。
