%0 Journal Article %1 Tabuchi2002 %A Tabuchi, Yachiyo %A Takamitsu, Yoshihiro %D 2002 %J Masui %K Adult; Anesthesia, Epidural; Spinal; Cerebral Palsy; Humans; Male; Nephrectomy; Perioperative Care; Preanesthetic Medication; Renal Dialysis %N 11 %P 1268--1271 %T Perioperative management for nephrectomy using combined spinal-epidural anesthesia with sedation in a patient with cerebral palsy under maintenance hemodialysis %V 51 %X A 43-year-old man (166 cm, 53.5 kg) with cerebral palsy on maintenance hemodialysis underwent a right nephrectomy for gross hematuria under combined spinal-epidural anesthesia (CSEA) with sedation. The patient suffered from hemiplegia, speech disturbance and low intelligence (approximately 6 years and 8 months). Following premedication with midazolam 4 mg, he was calm and cooperative. An analgesic level below T 10 was obtained by spinal (L 4-5) anesthesia using plain 0.5\% bupivacaine 4 ml. Further cephalad spread (below T 3) was secured by bolus (7 ml) and continuous (8.5 ml.h-1) administration of 2\% mepivacaine for thoracic epidural (T 10-11) anesthesia. Intravenous sedation (midazolam 0.08 mg.kg-1.h-1 and pentazocine 0.24 mg.kg-1.h-1) with 2 l.min-1 oxygen via nasal cannula was given during surgery. The operation and anesthesia times were 216 min and 330 min, respectively. Intraoperative bleeding was 1,158 g and the extracted kidney weighted 2,333 g. Following a prompt recovery with exclamation at the end of surgery, a bolus dose of epidural buprenorphine 0.2 mg combined with droperidol 2.5 mg was administered. Three hours after surgery, sleep was induced by brotizolam 0.25 mg orally. We accomplished a giant nephrectomy under CSEA with sedation in a patient with cerebral palsy receiving hemodialysis. Sufficient premedication using midazolam was profitable for CSEA in mental-retarded patient.

@article{Tabuchi2002, abstract = {A 43-year-old man (166 cm, 53.5 kg) with cerebral palsy on maintenance hemodialysis underwent a right nephrectomy for gross hematuria under combined spinal-epidural anesthesia (CSEA) with sedation. The patient suffered from hemiplegia, speech disturbance and low intelligence (approximately 6 years and 8 months). Following premedication with midazolam 4 mg, he was calm and cooperative. An analgesic level below T 10 was obtained by spinal (L 4-5) anesthesia using plain 0.5\% bupivacaine 4 ml. Further cephalad spread (below T 3) was secured by bolus (7 ml) and continuous (8.5 ml.h-1) administration of 2\% mepivacaine for thoracic epidural (T 10-11) anesthesia. Intravenous sedation (midazolam 0.08 mg.kg-1.h-1 and pentazocine 0.24 mg.kg-1.h-1) with 2 l.min-1 oxygen via nasal cannula was given during surgery. The operation and anesthesia times were 216 min and 330 min, respectively. Intraoperative bleeding was 1,158 g and the extracted kidney weighted 2,333 g. Following a prompt recovery with exclamation at the end of surgery, a bolus dose of epidural buprenorphine 0.2 mg combined with droperidol 2.5 mg was administered. Three hours after surgery, sleep was induced by brotizolam 0.25 mg orally. We accomplished a giant nephrectomy under CSEA with sedation in a patient with cerebral palsy receiving hemodialysis. Sufficient premedication using midazolam was profitable for CSEA in mental-retarded patient.}, added-at = {2014-07-19T21:37:32.000+0200}, author = {Tabuchi, Yachiyo and Takamitsu, Yoshihiro}, biburl = {https://www.bibsonomy.org/bibtex/25f6639b4953bd1a7c1e1f29297f93f3a/ar0berts}, groups = {public}, interhash = {73da1afd8ec462fdacdee9e5554177cc}, intrahash = {5f6639b4953bd1a7c1e1f29297f93f3a}, journal = {Masui}, keywords = {Adult; Anesthesia, Epidural; Spinal; Cerebral Palsy; Humans; Male; Nephrectomy; Perioperative Care; Preanesthetic Medication; Renal Dialysis}, month = Nov, number = 11, pages = {1268--1271}, pmid = {12481458}, timestamp = {2014-07-19T21:37:32.000+0200}, title = {[Perioperative management for nephrectomy using combined spinal-epidural anesthesia with sedation in a patient with cerebral palsy under maintenance hemodialysis]}, username = {ar0berts}, volume = 51, year = 2002 }