| Japanese |
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| Title | AICD埋込みの麻酔中のpEEGモニター |
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| Subtitle | 症例 |
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| Authors | 原康治*, 関一平**, 舘田武志*, 青木正*, 塚本毅*** |
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| Organization | *聖マリアンナ医科大学麻酔学教室, **聖マリアンナ医科大学横浜市西部病院救命センター, ***聖マリアンナ医科大学中央手術部 |
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| Journal | 循環制御 |
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| Volume | 20 |
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| Number | 1 |
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| Page | 98-101 |
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| Year/Month | 1999/ |
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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 | 埋込み型除細動器(automatic implantable cardioverter defibrillation以下AICD)は難治性, 薬物抵抗性の心室細動に対し適応があり1), 経静脈的に除細動電極とペーシングリードを心内(右室, 上大静脈, 冠静脈洞)に, 除細動器本体を左側胸壁皮下に埋め込むもので, 埋込みに際し全身麻酔を必要とする事が多い. AICDの埋込み時には心室細動の誘発試験が必要である. 頻拍, 細動の感知・認識からコンデンサーへの充電が開始しAICDが作働し, 除細動され洞調律に復するまでの時間に, 脳は虚血状態におちいる可能性がある2). AICDは現在, 心室頻拍(VT)及び心室細動(Vf)による突然死の予防法として注目されている治療法であり今後急速に普及する可能性があり, 麻酔管理が増加すると考えられる. 従って, 術中の脳機能に対するモニターについて考慮する必要がある. 今回我々は, AICD埋込み時の循環動態の変動と脳波(processed EEG:以下pEEG)と術後の合併症について検討した. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | |
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| English |
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| Title | The Processed-Electroencephalogram during Implantation of the Automatic Implantable Cardioverter Defibrillator |
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| Subtitle | |
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| Authors | Koji Hara*, Ippei Seki**, Takeshi Tateda*, Tadashi Aoki*, Takeshi Tukamoto*** |
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| Authors(kana) | |
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| Organization | *Department of Anesthesiology, St. Marianna University School of Medicine, **St. Marianna University School of Medicine Yokohama City Seibu Hospital Critical Care Center, ***St. Marianna University School of Medicine Division of Medical Electronics |
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| Journal | Circulation Control |
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| Volume | 20 |
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| Number | 1 |
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| Page | 98-101 |
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| Year/Month | 1999/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | An automatic implantable cardioverter defibrillator (AICD) terminates malignant ventricular tachyarrhythmias and therfore is effective in the prevention of sudden cardiac death from ventricular tachycardia (VT) or ventricular fibrillation (Vf). The insertion of AICD requires repeated induction of VT or Vf. Hence, hypotention and cerebral hypoperfusion occur in patients while the implantable cardioverter defibrillator is being tested. We used the processed electroencephalogram (pEEG) in 3 patients to evaluate transient cerebral hypoperfusion during AICD implantation. Spectral edge frequency 90 (SEF 90) of pEEG was measured in 3 patients undergoing AICD. SEF 90 was reduced significantly in two patients and was not changed in another. There were no neurologic complication in all 3 patients after AICD implantation. The pEEG could estimate cerebral perfusion, but furthter study will be required to confirm the relationship between pEEG and neurologic outcome after AICD implantation. |
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| Practice | Basic medicine |
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| Keywords | AICD, pEEG, SEF 90 |
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