title: [Anesthetic management of laparoscopic cholecystectomy for a patient with Churg-Strauss syndrome: a case report].
abstract: Churg-Strauss syndrome (CSS) is an uncommon disease characterized by bronchial asthma, eosinophilia and systemic vasculitis. Many patients with CSS are suffering from cardiovascular disorders, neurological disorders and/or renal disorders which are associated with systemic vasculitis. Cardiac diseases are considered as the main cause of the death in patients with CSS. Steroid administration is the standard pharmacological therapy for CSS. There are very few clinical reports concerning anesthetic management for the patients with CSS. We suppose that precise perioperative managements are required for the patients with CSS, including the appropriate control of bronchial asthma and the careful treatments of disorders in cardiovascular system, neurological system and/or kidney. In addition, we believe that the steroid cover should be considered during the perioperative period of the patients with CSS. Here, we describe an anesthetic management of a 28-year-old man with CSS undergoing laparoscopic cholecystectomy. General anesthesia was induced with midazolam and fentanyl. Rocuronium was administered to facilitate tracheal intubation. After tracheal intubation, anesthesia was maintained with sevoflurane and remifentanil. Prior to the surgery, 100 mg of hydrocortisone was administered for the steroid cover. The surgery was uneventful. The patient emerged from general anesthesia smoothly, and was extubated safely.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Koda
authors.forename: Masashi
authors.initials: M
authors.lastname: Uzawa
authors.forename: Haruka
authors.initials: H
authors.lastname: Kimura
authors.forename: Masaki
authors.initials: M
authors.lastname: Harada
authors.forename: Norie
authors.initials: N
authors.lastname: Sambe
authors.forename: Takayuki
authors.initials: T
authors.lastname: Sugano
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ide
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kitamura
authors.forename: Megumi
authors.initials: M
authors.lastname: Tagami
mesh_terms: D000328:Adult; D000768:Anesthesia, General / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic; D015267:Churg-Strauss Syndrome / Q000601:surgery*; D005283:Fentanyl; D006801:Humans; D008297:Male; D008738:Methyl Ethers; D008874:Midazolam; D010880:Piperidines; D000077208:Remifentanil; D000077149:Sevoflurane
chemical_list: D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil; D008874:Midazolam; D005283:Fentanyl