title: [Perioperative management of a patient with a history of over-the-counter analgesic abuse for 20 years].
abstract: A 67-year-old man, complicated with liver cirrhosis, diabetes mellitus, and ischemic heart disease, was scheduled for gastrectomy. He had been taking an over-the-counter (OTC) analgesic containing acetaminophen, ethenzamid and caffeine for 20 years, and refused to stop taking it preoperatively. He received general anesthesia with isoflurane, supplemented with fentanyl and midazolam. Muscle relaxation was obtained with vecuronium. Isosorbide was infused continuously to prevent myocardial ischemia. The anesthetic course was uneventful. Postoperatively, the patient experienced no difficulty in abstaining from taking the OTC analgesic. The patient's perioperative course indicates that he was not dependent on this OTC drug, but he needed this medication only to ameliorate his preoperative anxiety or depressive mood.
authors.affiliation: Department of Anesthesia, Kyoto City Hospital.
authors.forename: K
authors.initials: K
authors.lastname: Nakamura
authors.forename: Y
authors.initials: Y
authors.lastname: Ogino
authors.forename: R
authors.initials: R
authors.lastname: Kitamura
authors.forename: Y
authors.initials: Y
authors.lastname: Matsuoka
authors.forename: S
authors.initials: S
authors.lastname: Kusunose
mesh_terms: D000082:Acetaminophen; D000368:Aged; D018712:Analgesics, Non-Narcotic; D000768:Anesthesia, General; D002110:Caffeine; D005743:Gastrectomy; D006801:Humans; D008297:Male; D004366:Nonprescription Drugs; D019990:Perioperative Care; D012457:Salicylamides; D013274:Stomach Neoplasms / Q000601:surgery; D019966:Substance-Related Disorders
chemical_list: D018712:Analgesics, Non-Narcotic; D004366:Nonprescription Drugs; D012457:Salicylamides; D000082:Acetaminophen; D002110:Caffeine; C018935:ethenzamide