| Japanese |
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| Title | 麻酔中に低Ca血症を生じた褐色細胞腫の1例 |
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| Subtitle | 症例 |
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| Authors | 戸田耕子, 館田武志, 田尻治, 野田宗慶, 青木正, 高橋敬蔵 |
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| Organization | 聖マリアンナ医科大学麻酔学教室 |
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| Journal | 循環制御 |
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| Volume | 16 |
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| Number | 4 |
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| Page | 571-573 |
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| Year/Month | 1995/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「はじめに」褐色細胞腫の麻酔管理については, 循環管理の方法に関して様々な報告がされている. しかし, 電解質バランスの異常についての報告は多発性内分泌腫瘍の症例以外は稀である. 今回我々は, 腫瘍摘出後に高度の低Ca血症を来たし, 血圧低下が遷延した褐色細胞腫の麻酔症例を経験したので報告する. 「症例」31歳の女性である. 5年前より動悸, 1年前より発作性高血圧を認め, 精査により褐色細胞腫と診断され, 腫瘍摘出術が予定された. 既往歴, 家族歴に特記すべきことはなかった. 術前検査では末梢血液検査, 生化学検査, 電解質に異常は認められなかった. 循環血液量は2927mlであった. 内分泌検査では血中ノルエピネフリンが19ng/ml(正常値0.05-0.4ng/ml)と高値を示した. 画像診断から, 腹部大動脈交感神経節より発生した右後腹膜腫瘍の存在が確認された. 甲状腺, 副甲状腺, 肝, 腎および心機能に異常は認められなかった. 血圧のコントロールとして, 術前よりラベタロールを一日300mg, 手術当日朝まで服用させた. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Pheochromocytoma, Hypocalcemia, Hypotension |
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| English |
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| Title | A Case of Hypocalcemia during Surgery of Pheochromocytoma |
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| Authors | Koko Toda, Takeshi Tateda, Muneyoshi Noda, Osamu Tajiri, Tadashi Aoki, Keizo Takahashi |
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| Authors(kana) | |
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| Organization | Department of Anesthesiology, St Marianna University School of Medicine |
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| Journal | Circulation Control |
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| Volume | 16 |
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| Number | 4 |
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| Page | 571-573 |
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| Year/Month | 1995/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | This is a 31-year-old female who has had a episode of palpitation since five years ago, and developed hypertention one year ago. The patient was diagnosed pheochromocytoma with clinical and laboratory findings, and scheduled for resection of an ectopic tumor of pheochromocytoma, which was located on abdominal aortic sympathetic ganglion, under general anesthesia combined with epidural block. Blood pressure was unstable and uncontrollable during surgery. Immediately after resection of the tumor, systolic blood pressure decreased to 60 mmHg. Hypotension continued despite of administration of high dose of norepinephrine, dobutamine, and massive blood with fresh frozen plasma (FFP) transfusion. The serum ionized calcium (Ca++) level was 0.42 mmol/l at 20 min after the removal of the tumor. The Ca++ level and hemodynamic states were improved gradually with the intravenous infusion of calcium gulconate 1275 mg. Hypocalcemia might be caused by vasodilation after resection of the tumor and massive transfusion, especially rapid infusion of FFP. We conclude that massive transfusion, especially FFP, increases the risk of hypocalcemia during resection of pheochromocytoma. (Circ Cont 16：571〜573, 1995) |
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| Practice | Basic medicine |
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| Keywords | Pheochromocytoma, Hypocalcemia, Hypotension |
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