title: [A case of total intravenous anesthesia with propofol, fentanyl and ketamine for lateral segmentectomy of the liver under pringle maneuver].
abstract: We successfully anesthetized an 80-year-old female for Pringle maneuver which was applied at the time of liver transection and consisted of cross-clamping the hepatoduodenal ligament for 25 minutes and releasing the clamp for 2 minutes until the completion of the liver transection. Anesthesia chosen was total intravenous anesthesia with propofol, fentanyl and ketamine (PFK) in combination with epidural anesthesia. The plasma concentrations of propofol at pre-, intra-, and post-Pringle maneuver under the intravenous infusion of propofol at 3 mg.kg-1.h-1 were 0.84, 1.49, and 1.29 micrograms.ml-1, respectively. All operative procedures were done uneventfully and recovery from anesthesia was prompt after the end of propofol infusion. Transient increases in liver enzymes were seen during early postoperative period, but no signs of hepatic failure were observed. In this patient, PFK anesthesia was useful and safe for the liver transection with Pringle maneuver.
authors.affiliation: Division of Anesthesiology, Okinawa Prefectural Miyako Hospital.
authors.forename: M
authors.initials: M
authors.lastname: Kakinohana
authors.forename: T
authors.initials: T
authors.lastname: Saitoh
authors.forename: O
authors.initials: O
authors.lastname: Kakinohana
authors.forename: Y
authors.initials: Y
authors.lastname: Okuda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000767:Anesthesia, Epidural; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous / Q000097:blood; D003250:Constriction; D005260:Female; D005283:Fentanyl; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007649:Ketamine; D015742:Propofol / Q000097:blood
chemical_list: D018686:Anesthetics, Intravenous; D007649:Ketamine; D005283:Fentanyl; D015742:Propofol