Desflurane Anesthesia and Intraoperative Motor Evoked Potential Monitoring of a Patient with Cervical Cavernous Hemangioma Complicated with Liver Cirrhosis
We report a 64-year-old man with cervical cavern- ous hemangioma. He had liver cirrhosis caused by non- alcoholic steatohepatitis (NASH) with stage C of Child- Pugh classification. Neurosurgeon requested transcra- nial myogenic motor evoked potential (MEP) monitor- ing to prevent postoperative neurological deterioration. We carried out anesthetic management and intraoper- ative myogenic MEP monitoring by desflurane and remifentanil. Intraoperative MEP monitoring is com- monly conducted under total intravenous anesthesia (TIVA). Propofol and remifentanil are routinely used anesthetics. For this patient, it was difficult to use pro- pofol because of severe liver dysfunction. Therefore, we used desflurane at 0.6 MAC (minimum alveolar con- centration) this time. Though there was slight ampli- tude decrement, it was possible to monitor MEP. After the operation, we extubated the patient in about 7 minutes and could confirm neurological functions immediately. Desflurane is beneficial to prevent aggra- vation of the liver function and to produce rapid awak- ening from anesthesia.
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2016 |
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| Erschienen: |
2016 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:65 |
|---|---|
| Enthalten in: |
Masui. The Japanese journal of anesthesiology - 65(2016), 12 vom: 01. Dez., Seite 1263-1267 |
| Sprache: |
Japanisch |
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| Beteiligte Personen: |
Matayoshi, Hiroaki [VerfasserIn] |
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| Themen: |
Anesthetics, Inhalation |
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| Anmerkungen: |
Date Completed 13.12.2018 Date Revised 13.12.2018 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM290130689 |
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| 520 | |a We report a 64-year-old man with cervical cavern- ous hemangioma. He had liver cirrhosis caused by non- alcoholic steatohepatitis (NASH) with stage C of Child- Pugh classification. Neurosurgeon requested transcra- nial myogenic motor evoked potential (MEP) monitor- ing to prevent postoperative neurological deterioration. We carried out anesthetic management and intraoper- ative myogenic MEP monitoring by desflurane and remifentanil. Intraoperative MEP monitoring is com- monly conducted under total intravenous anesthesia (TIVA). Propofol and remifentanil are routinely used anesthetics. For this patient, it was difficult to use pro- pofol because of severe liver dysfunction. Therefore, we used desflurane at 0.6 MAC (minimum alveolar con- centration) this time. Though there was slight ampli- tude decrement, it was possible to monitor MEP. After the operation, we extubated the patient in about 7 minutes and could confirm neurological functions immediately. Desflurane is beneficial to prevent aggra- vation of the liver function and to produce rapid awak- ening from anesthesia | ||
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