title: [Sevoflurane anesthesia for pancreatectomy in an infant with nesidioblastosis].
abstract: We report a case of nesidioblastosis, which is characterized by hyperinsulinism due to a diffuse increase in the number of beta-cells in the pancreas and, consequently, severe hypoglycemia. The patient was a 79-day-old boy. He had been suffering from severe hypoglycemia despite aggressive treatment, including glucose loading and administration of glucocorticoid and diazoxide. Pancreatectomy was performed. Anesthesia was induced by thiamilal 25 mg and vecronium and was maintained by 1 to 2% sevoflurane in 65% nitrous oxide and fentanyl 5 micrograms. No hemodynamic instability was observed during anesthesia. Blood glucose level was maintained around 200 mg.dl-1 without any hyperglycemic event by continuous infusion of 20% glucose at the rate of 14.5 mg.kg-1.min-1, which was calculated from the daily glucose demand to prevent hypoglycemia preoperatively.
authors.affiliation: Division of Anesthesia, Hokkaido Children's Medical Center, Otaru 047-0261.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sato
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Hirata
authors.forename: Yuki
authors.initials: Y
authors.lastname: Toyoshima
authors.forename: Shin
authors.initials: S
authors.lastname: Kawana
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Namiki
mesh_terms: D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology; D007223:Infant; D007430:Intraoperative Care; D008297:Male; D008738:Methyl Ethers; D010180:Pancreatectomy; D010182:Pancreatic Diseases / Q000150:complications / Q000601:surgery*; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D005947:Glucose