[Anesthetic management of a patient with chronic spinal cord injury for laparoscopic cholecystectomy].
Spinal cord injury (SCI) is a rare disease that offers challenges to anesthesiologists, while laparoscopic cholecystectomy (LC) has become common in recent years. We report a case of adult patient with chronic high SCI who underwent LC. A 62-year-old man, a known case of cervical SCI, was presented for LC. Anesthetic problems included circulatory and respiratory complications because of both SCI and pneumoperitoneum. Anesthesia was induced with propofol and a standard endotracheal tube was inserted with vecuronium; and thereafter anesthesia was maintained with small bolus doses of fentanyl and sevoflurane inhalation in the absence of epidural block. The intra- and post-operative course was completely uneventful without any episode of autonomic hyperreflexia. Due to a lack of sensory and motor function, SCI patients will receive little benefit from minimally invasive laparoscopic procedures. In conclusion, compared to open laparotomy, LC will minimize surgical trauma and hospital stay, but may not always minimize complications in anesthetic management. To the best of our knowlegde this is the first report in the literature which describes anesthesia for laparoscopic surgery in a SCI patient.
Sugiura
Takahiro
T
Department of Anesthesia, National Hospital Organization Tokyo Medical Center, Tokyo 152-8902.
Kobayashi
Yoshiro
Y
Suga
Kikuko
K
Yoshida
Akiko
A
Satoh
Naoko
N
Kaneko
Takehiko
T
D000769:Anesthesia, Inhalation; D017081:Cholecystectomy, Laparoscopic; D006801:Humans; D008297:Male; D008875:Middle Aged; D013119:Spinal Cord Injuries / Q000150:complications*