先天性高インスリン血症患児に対する膵頭部切除術の麻酔経験

Translated title of the contribution: Anesthetic Management during Pancreatic Head Resection for Congenital Hyperinsulinemia

小野 雄介, 水田 幸恵, 河﨑 翔, 白水 和宏, 辛島 裕士, 外 須美夫

Research output: Contribution to journalArticlepeer-review

Abstract

We experienced anesthetic management during pancreatectomy in a pediatric patient with congenital hyperinsulinemia. The patient was 6 months of age, measured 65.2 cm in length (-1.2SD), and weighed 10.6 kg (+3.2SD). His blood sugar was 24 mg/dL at birth, so he received an insulin secretion suppressant and dextrose. However, blood sugar management was difficult and hypoglycemia occurred. During pancreatectomy, anesthesia was maintained with oxygen, air, sevoflurane, fentanyl, and remifentanil. Dextrose administration was regulated and ranged from 7 mg/kg/min to 1 mg/kg/min based on blood sugar measurement. The patient's blood sugar rose to a maximum of 300 mg/dL but gradually decreased with insulin administration, stabilizing at 150 mg/dL. Hypoglycemia did not occur intraoperatively. We were able to achieve blood sugar stability with appropriate dextrose administration. Because blood insulin concentration changes dramatically during pancreatectomy for congenital hyperinsulinemia, frequent blood sugar measurement and dextrose infusion adjustment are required during anesthesia.
Translated title of the contributionAnesthetic Management during Pancreatic Head Resection for Congenital Hyperinsulinemia
Original languageJapanese
Pages (from-to)286-290
Number of pages5
Journal日本臨床麻酔学会誌
Volume36
Issue number3
DOIs
Publication statusPublished - 2016

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