| English |
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| Title | Anesthetic Management for a Patient with Wolff-Parkinson-White Syndrome undergoing Tonsillectomy |
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| Subtitle | |
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| Authors | Masayuki Oshima, Yoichi Shimada, Atsuhiro Sakamoto, Ryo Ogawa |
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| Authors(kana) | |
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| Organization | Department of Anesthesiology, Nippon Medical School |
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| Journal | Circulation Control |
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| Volume | 24 |
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| Number | 2 |
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| Page | 155-156 |
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| Year/Month | 2003/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | We present here a patient with Wolff-Parkinson-White (WPW) syndrome, who was anesthetized with propofol during palatine tonsillectomy. [Case] A palatine tonsillectomy was planned for a 33-yearold 165 cm and 59 kg, female with chronic tonsillitis. Preoperative examination indicated no specific findings except for the WPW syndrome detected by electrocardiogram (Fig.). Based on a more detailed examination using a Holter electrocardiogram, she was diagnosed as having WPW syndrome. [Anesthetic management] No preanesthetic medication was administered to the patient. After establishing the venous line on the left forearm, 0.025 mg of fentanyl was administered intravenously and target controlled infusion was carried out to obtain a target blood concentration of propofol of 3 μg/ml. Vecuronium (3 mg) was also administered intravenously to facilitate tracheal intubation. Anesthesia was maintained using fentanyl (total amount of 0.1 mg), propofol (target blood concentration of 3-4 μg/ml), nitrous oxide and oxygen. In addition to local administration of 1 % lidocaine containing epinephrine (5 μg/ml) around the tonsil, disopyramide was continuously administered intravenously at 200 mg/h to avoid tachyarrythmias. Delta wave was apparent from the induction to the end of anesthesia, but perioperative hemodynamics were relatively stable. Postoperatively, disappearance of the muscle relaxant action of vecuronium was confirmed and the patient was extubated without antagonizing the muscle relaxant effect, and returned to her ward. |
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| Practice | Basic medicine |
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| Keywords | Lung ischemia reperfusion injury, Lung transplantation, Preconditioning, N-methyl-1-deoxynojirimycin |
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