中枢性尿崩症患者の全身麻酔経験

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The central diabetes insipidus is a disease which causes the parasecretion of antidiuretic hormone through the degeneration of hypothalamus and the posterior-lobe-of-hypophysis system, and makes polyuria, the polyposia, and dipsesis the cardinal symptoms. For this reason, a critical complication may be caused to into the trap from the edema because of the water intoxication by oliguria, a generalized seizure, and the electrolyte imbalance by polyuria. We experienced the general anesthesia management of a patient who has central diabetes insipidus. A 25-year-old male patient (height 168cm, weight 50kg), diagnosed with a left side fracture of the mandible, was scheduled for open reduction pexia under general anesthesia. Anesthesia was induced with propofol and maintained with N_2O, O_2 and sevoflurane. During the operation the patient was kept on controlled ventilation monitoring by percutaneous SpO_2, arterial blood gas analysis, etc., and furthermore, had the central venous pressure meosured as one of the indexes of body fluid management. But the oliguria trend was accepted during the operation. So self-sustaing administration of the prostagrandin E1 and the furosemide of the diuretic of a loop system was prescribed for the patient, because the oliguria has not improved although management through a transfusion load was tried. It is important to take great care of the management of a patient with diabetes insipidus with regard to fluid balance, urine volume and electrolytes management.
岩手医科大学歯学会の論文
2006-08-16

中枢性尿崩症患者の全身麻酔経験

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