[Anesthetic management for pancreaticoduodenectomy in a patient with Charcot-Marie-Tooth disease and liver cirrhosis].
A 68-year-old man was scheduled for pancreaticoduodenectomy under general anesthesia. He was suffering from Charcot-Marie-Tooth disease (CMTD) for 34 years, and complicated with liver cirrhosis. Anesthesia was induced with propofol and fentanyl, and maintained with oxygen-air-sevoflurane and remifentanil. Epidural block was not used because the patient had coagulation abnormality and thrombocytopia. Rocuronium was injected intravenously for tracheal intubation, supplemented as required using an electrical nerve stimulator. The longer duration of action of rocuronium was observed in this case because the patient was complicated with CMTD and liver cirrhosis. We suggest that monitoring neuromuscular function may be necessary to detect subtle residual neuromuscular blockade when rocuronium is used in a patient with CMTD and liver dysfunction.
Department of Anesthesiology, Dokkyo Medical University Hospital, Tochigi 321-0293.
Tomoki
T
Hashimoto
Minori
M
Morita
Shinsuke
S
Hamaguchi
Toshimitsu
T
Kitajima
D000230:Adenocarcinoma / Q000150:complications / Q000601:surgery*; D000368:Aged; D000732:Androstanols; D000768:Anesthesia, General; D002607:Charcot-Marie-Tooth Disease / Q000150:complications*; D004379:Duodenal Neoplasms / Q000150:complications / Q000601:surgery*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D016343:Monitoring, Intraoperative; D019148:Neuromuscular Blockade; D016577:Pancreaticoduodenectomy; D000077123:Rocuronium
D000732:Androstanols; D000077123:Rocuronium