| Japanese |
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| Title | 褐色細胞腫摘出術中, 種々の循環・代謝緒量を測定し得た1症例 |
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| Subtitle | 症例 |
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| Authors | 佐藤圭路*, 赤田典子*, 角真理子*, 野村岳志*, 中谷俊彦**, 斎藤洋司**, 内田博*, 中村裕二*, 小坂義弘* |
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| Authors(kana) | |
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| Organization | *島根医科大学麻酔学教室, **島根医科大学集中治療部 |
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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 | 578-582 |
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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 | 褐色細胞腫摘出術においては, 循環変動のみならず, 呼吸・代謝動態においても急激な変化が生ずる可能性がある. 近年, 術中モニターとして, 肺動脈カテーテル(PAカテ)のみならず, 経食道心エコー法(TEE)が普及し, これらから得られる情報をもとに, より緻密な麻酔管理が行えるようになった1). 今回は, PAカテとTEEを併用し, 種々の循環・酸素代謝諸量を測定し, 麻酔管理に有用であった褐色細胞腫摘出術の1例を経験したので報告する. 「症例」60歳女性で, 身長148cm, 体重48kgであった. 家族歴：姉2人が高血圧性脳内出血にて死亡. 既往歴：1988年10月, 左副腎褐色細胞腫の診断にて当院外科にて腫瘍摘出術を受けた. 現病歴：1994年秋頃より頭痛, 動悸が出現. 精査の結果左副腎褐色細胞腫再発と診断された. 理学所見：血圧は安静時には130〜120/80〜70mmHg, 発作時には180〜160/100〜90mmHgであった. 心音, 呼吸音に異常はなかった. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Pheochromocytoma, Transesophagealechocardiogram, Pulmonary artery catheter, O2 delivery, O2 consumption |
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| English |
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| Title | A CASE of Pheochromocytoma of which Anesthetic Management was performed with Several Cardiovascular and Metabolic Indexes |
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| Authors | Keiji Satoh*, Noriko Akata*, Mariko Sumi*, Takesi Nomura*, Toshihiko Nakatani**, Youji Saitoh**, Hiroshi Uchida*, Yuji Nakamura*, Yoshihiro Kosaka* |
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| Authors(kana) | |
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| Organization | *Department of Anesthesioiogy, Shimane Medical University, **Department of Intensive Care Medicine, Shimane Medical University |
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| Journal | Circulation Control |
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| Volume | 16 |
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| Number | 4 |
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| Page | 578-582 |
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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 | We report a case of pheochromocytoma of which anesthetic managenent was performed with several cardiovascular and metabolic indexes measured by pulmonary artery (PA) catheter and transesophageal echocardiogram (TEE). A 60 years-old woman was scheduled for elective surgery of the recurrent pheochromocytoma, and GO-Sevoflurane anesthesia combined with epidural blockade was selected. Cardiac index (Cl) showed 2.58 l/min・m2 at the beginning of the surgery, which increased dramatically to 5.5〜6.4l/min・m2 after tumor resection. Accordingly, systemic vascular resistance index (SVRI) decreased from 1988 to 809 dyne・sec/cm5・m2. Pulmonary vascular resistance (PVR) was almost constant level throughout the surgery. As for the metabolic indexes, oxygen consumption (Vo2) and oxygen delivery (Do2) were increased, so that the extraction ratio (O2ER) did not show remarkable change. With reference to these values and TEE findings, essential treatments of continuous infusions of catecholamines, prostaglandin E1 and calcium antagonists, as well as blood transfusion, were performed and fractional shortening (FS) and left ventricular end-diastolic volume (LVEDV) were stable during the anesthetic course. We attribute this successful case to the careful monitoring of PAP and TEE, taking not only cardiovasucular but also metabolic indexes into consideration. (Circ Cont 16：578〜582, 1995) |
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| Practice | Basic medicine |
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| Keywords | Pheochromocytoma, Transesophagealechocardiogram, Pulmonary artery catheter, O2 delivery, O2 consumption |
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