Anesthetic management for a patient with significant orthostatic hypotension probably due to pure autonomic failure

Kentaro Tokuda, Yoshimasa Motoyama, Yoichiro Kai, Yoshiro Sakaguchi, Sumio Hoka

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

A 73-year-old man with severe orthostatic hypotension was scheduled for open cholecystectomy. His blood pressure was 126/80 mmHg in the supine position and 50/30 mmHg in the upright posture. Preoperative autonomic function tests suggested that postsynaptic fibers of the sympathetic nervous system were impaired, and the disorder was probably due to pure autonomic failure. Anesthesia was induced with thiamylal and vecuronium, and maintained with sevoflurane (3%) and fentanyl (100 μg). Epidural anesthesia was used in the latter half of the operation. Meticulous use of vasoactive drugs such as dopamine and phenylephrine as well as adequate maintenance of systemic blood volume by infusion of a crystalloid solution enabled his hemodynamic condition to become stable during anesthesia.

Original languageEnglish
Pages (from-to)1010-1013
Number of pages4
JournalJapanese Journal of Anesthesiology
Volume58
Issue number8
Publication statusPublished - Aug 1 2009

Fingerprint

Pure Autonomic Failure
Orthostatic Hypotension
Anesthetics
Anesthesia
Thiamylal
Vecuronium Bromide
Epidural Anesthesia
Supine Position
Sympathetic Nervous System
Cholecystectomy
Fentanyl
Phenylephrine
Blood Volume
Posture
Dopamine
Hemodynamics
Maintenance
Blood Pressure
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

Anesthetic management for a patient with significant orthostatic hypotension probably due to pure autonomic failure. / Tokuda, Kentaro; Motoyama, Yoshimasa; Kai, Yoichiro; Sakaguchi, Yoshiro; Hoka, Sumio.

In: Japanese Journal of Anesthesiology, Vol. 58, No. 8, 01.08.2009, p. 1010-1013.

Research output: Contribution to journalArticle

Tokuda, Kentaro ; Motoyama, Yoshimasa ; Kai, Yoichiro ; Sakaguchi, Yoshiro ; Hoka, Sumio. / Anesthetic management for a patient with significant orthostatic hypotension probably due to pure autonomic failure. In: Japanese Journal of Anesthesiology. 2009 ; Vol. 58, No. 8. pp. 1010-1013.
@article{ec0f6ef3cb8d4593b47a8428083d77f2,
title = "Anesthetic management for a patient with significant orthostatic hypotension probably due to pure autonomic failure",
abstract = "A 73-year-old man with severe orthostatic hypotension was scheduled for open cholecystectomy. His blood pressure was 126/80 mmHg in the supine position and 50/30 mmHg in the upright posture. Preoperative autonomic function tests suggested that postsynaptic fibers of the sympathetic nervous system were impaired, and the disorder was probably due to pure autonomic failure. Anesthesia was induced with thiamylal and vecuronium, and maintained with sevoflurane (3{\%}) and fentanyl (100 μg). Epidural anesthesia was used in the latter half of the operation. Meticulous use of vasoactive drugs such as dopamine and phenylephrine as well as adequate maintenance of systemic blood volume by infusion of a crystalloid solution enabled his hemodynamic condition to become stable during anesthesia.",
author = "Kentaro Tokuda and Yoshimasa Motoyama and Yoichiro Kai and Yoshiro Sakaguchi and Sumio Hoka",
year = "2009",
month = "8",
day = "1",
language = "English",
volume = "58",
pages = "1010--1013",
journal = "Japanese Journal of Anesthesiology",
issn = "0021-4892",
publisher = "Kokuseido Publishing Co. Ltd",
number = "8",

}

TY - JOUR

T1 - Anesthetic management for a patient with significant orthostatic hypotension probably due to pure autonomic failure

AU - Tokuda, Kentaro

AU - Motoyama, Yoshimasa

AU - Kai, Yoichiro

AU - Sakaguchi, Yoshiro

AU - Hoka, Sumio

PY - 2009/8/1

Y1 - 2009/8/1

N2 - A 73-year-old man with severe orthostatic hypotension was scheduled for open cholecystectomy. His blood pressure was 126/80 mmHg in the supine position and 50/30 mmHg in the upright posture. Preoperative autonomic function tests suggested that postsynaptic fibers of the sympathetic nervous system were impaired, and the disorder was probably due to pure autonomic failure. Anesthesia was induced with thiamylal and vecuronium, and maintained with sevoflurane (3%) and fentanyl (100 μg). Epidural anesthesia was used in the latter half of the operation. Meticulous use of vasoactive drugs such as dopamine and phenylephrine as well as adequate maintenance of systemic blood volume by infusion of a crystalloid solution enabled his hemodynamic condition to become stable during anesthesia.

AB - A 73-year-old man with severe orthostatic hypotension was scheduled for open cholecystectomy. His blood pressure was 126/80 mmHg in the supine position and 50/30 mmHg in the upright posture. Preoperative autonomic function tests suggested that postsynaptic fibers of the sympathetic nervous system were impaired, and the disorder was probably due to pure autonomic failure. Anesthesia was induced with thiamylal and vecuronium, and maintained with sevoflurane (3%) and fentanyl (100 μg). Epidural anesthesia was used in the latter half of the operation. Meticulous use of vasoactive drugs such as dopamine and phenylephrine as well as adequate maintenance of systemic blood volume by infusion of a crystalloid solution enabled his hemodynamic condition to become stable during anesthesia.

UR - http://www.scopus.com/inward/record.url?scp=69549103292&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=69549103292&partnerID=8YFLogxK

M3 - Article

C2 - 19702221

AN - SCOPUS:69549103292

VL - 58

SP - 1010

EP - 1013

JO - Japanese Journal of Anesthesiology

JF - Japanese Journal of Anesthesiology

SN - 0021-4892

IS - 8

ER -