結節性硬化症の麻酔中脳波モニター使用経験

脂腺腫・癲癇・精神発達遅延・発生性上室性頻脈を有する結節性硬化症の麻酔を経験した.患者は5歳男児で抗痙攣薬の投与によっても数回/日の痙攣発作を認めていた.麻酔は酸素-笑気-イソフルレンによる全身麻酔を行ない,同時にLife Scan (Neurometrics社製)を用い術中脳波モニタリングを行なった.脳波モニター上,麻酔導入・手術中・覚醒時において脳波異常を認めず,手術は無事終了した.結節性硬化症は,多発性の腺腫を有する疾患であり,本症例に認められた皮膚・脳・心臓以外に肺・腎・骨・内分泌腺などに発生することがあり,術前の十分な検索が麻酔管理上必要である.さらに,中枢神経系異常を起こしうる患者...

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Published in日本臨床麻酔学会誌 Vol. 13; no. 3; pp. 331 - 335
Main Authors 金谷, 憲明, 藤田, 智, 松本, 真希, 並木, 昭義
Format Journal Article
LanguageJapanese
Published 日本臨床麻酔学会 1993
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ISSN0285-4945
1349-9149
DOI10.2199/jjsca.13.331

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Abstract 脂腺腫・癲癇・精神発達遅延・発生性上室性頻脈を有する結節性硬化症の麻酔を経験した.患者は5歳男児で抗痙攣薬の投与によっても数回/日の痙攣発作を認めていた.麻酔は酸素-笑気-イソフルレンによる全身麻酔を行ない,同時にLife Scan (Neurometrics社製)を用い術中脳波モニタリングを行なった.脳波モニター上,麻酔導入・手術中・覚醒時において脳波異常を認めず,手術は無事終了した.結節性硬化症は,多発性の腺腫を有する疾患であり,本症例に認められた皮膚・脳・心臓以外に肺・腎・骨・内分泌腺などに発生することがあり,術前の十分な検索が麻酔管理上必要である.さらに,中枢神経系異常を起こしうる患者の術中管理に連続測定可能な簡便な脳波モニターは有用であると思われた.
AbstractList 脂腺腫・癲癇・精神発達遅延・発生性上室性頻脈を有する結節性硬化症の麻酔を経験した.患者は5歳男児で抗痙攣薬の投与によっても数回/日の痙攣発作を認めていた.麻酔は酸素-笑気-イソフルレンによる全身麻酔を行ない,同時にLife Scan (Neurometrics社製)を用い術中脳波モニタリングを行なった.脳波モニター上,麻酔導入・手術中・覚醒時において脳波異常を認めず,手術は無事終了した.結節性硬化症は,多発性の腺腫を有する疾患であり,本症例に認められた皮膚・脳・心臓以外に肺・腎・骨・内分泌腺などに発生することがあり,術前の十分な検索が麻酔管理上必要である.さらに,中枢神経系異常を起こしうる患者の術中管理に連続測定可能な簡便な脳波モニターは有用であると思われた.
Author 並木, 昭義
松本, 真希
藤田, 智
金谷, 憲明
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References 6) Cosnett JE, Gibb BH: Tuberous sclerosis and cardiac arrhythmia in three Zulu Patients. Brit Med J 2: 672-673, 1969
5) Taylor TR: Tuberous sclerosis presenting as cardiac arrhythmia. Brit Heart J 30: 132-134, 1968
9) Chonko AM, Weiss SM, Stein JH, et al.: Renal involvement in tuberous sclerosis. Am J Med 56: 124-132, 1974
1) 北村恵津子,薦田節子,藤森貢:結節性硬化症(Bourneville's disease)と麻酔.麻酔26: 332～334, 1977
7) Tsakraklides V, Burke B, Mastri A, et al.: Rhabdomyomas of heart: a report of four cases. Am J Dis Child 128: 639-646, 1974
11) Sareen CK, Ruvalcaba RH, Scotvold MJ, et al. Tuberous sclerosis. Clinical, endocrine, and metabolic studies. Am J Dis Child 123: 34-39, 1972
12) Ghignone M, Quintin L, Duke PC, et al.: Effects of clonidine on narcotic erquirements and hemodynamic response during induction of fentanyl anesthesia and endotracheal intubatoion. Anesthesiolgy 64: 36-42, 1986
10) Gutman A, Leffkowitz M: Tuberous sclerosis associated with spontaneous hypoglycaemia. Brit Med J 5159: 1065-1068, 1959
2) 豊田幹夫,志賀健人,馬場祥子ほか: Bourneville-Pringle母斑症の麻酔経験.麻酔27: 75～78, 1978
3) Martz Jr DG, Schreidman DL, Jane Majasko M: Neurological diseases, Anesthesia and Uncommon Diseases. 3rd ed. Edited by Katz J, Benumof JL, Kadis LB. Philadelphia, Saunders, 1990, p 577-579
4) Adams RD: Neurocutaneous diseases, Dermatology in General Medicine. 3rd ed. Edited by Fizpatrick TB, Eisen AZ, Wolff K, et al. New York, McGrawHill, 1987, p 2O29-2032
8) O' Callaghan TJ, Edwards JA, Tobin M, et al. Tuberous sclerosis with striking renal involvement in a family. Arch Intern Med 135: 1082-1087, 1975
13) Michenfelder JD: Anesthesia and the Brain. New York, Churchill Livingstone, 1988, p 87-88
References_xml – reference: 8) O' Callaghan TJ, Edwards JA, Tobin M, et al. Tuberous sclerosis with striking renal involvement in a family. Arch Intern Med 135: 1082-1087, 1975
– reference: 2) 豊田幹夫,志賀健人,馬場祥子ほか: Bourneville-Pringle母斑症の麻酔経験.麻酔27: 75～78, 1978
– reference: 9) Chonko AM, Weiss SM, Stein JH, et al.: Renal involvement in tuberous sclerosis. Am J Med 56: 124-132, 1974
– reference: 11) Sareen CK, Ruvalcaba RH, Scotvold MJ, et al. Tuberous sclerosis. Clinical, endocrine, and metabolic studies. Am J Dis Child 123: 34-39, 1972
– reference: 12) Ghignone M, Quintin L, Duke PC, et al.: Effects of clonidine on narcotic erquirements and hemodynamic response during induction of fentanyl anesthesia and endotracheal intubatoion. Anesthesiolgy 64: 36-42, 1986
– reference: 10) Gutman A, Leffkowitz M: Tuberous sclerosis associated with spontaneous hypoglycaemia. Brit Med J 5159: 1065-1068, 1959
– reference: 1) 北村恵津子,薦田節子,藤森貢:結節性硬化症(Bourneville's disease)と麻酔.麻酔26: 332～334, 1977
– reference: 4) Adams RD: Neurocutaneous diseases, Dermatology in General Medicine. 3rd ed. Edited by Fizpatrick TB, Eisen AZ, Wolff K, et al. New York, McGrawHill, 1987, p 2O29-2032
– reference: 6) Cosnett JE, Gibb BH: Tuberous sclerosis and cardiac arrhythmia in three Zulu Patients. Brit Med J 2: 672-673, 1969
– reference: 7) Tsakraklides V, Burke B, Mastri A, et al.: Rhabdomyomas of heart: a report of four cases. Am J Dis Child 128: 639-646, 1974
– reference: 3) Martz Jr DG, Schreidman DL, Jane Majasko M: Neurological diseases, Anesthesia and Uncommon Diseases. 3rd ed. Edited by Katz J, Benumof JL, Kadis LB. Philadelphia, Saunders, 1990, p 577-579
– reference: 13) Michenfelder JD: Anesthesia and the Brain. New York, Churchill Livingstone, 1988, p 87-88
– reference: 5) Taylor TR: Tuberous sclerosis presenting as cardiac arrhythmia. Brit Heart J 30: 132-134, 1968
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