Anesthetic Management of a Patient with Osler-Rendu-Weber Disease During Laparoscopic Nephrectomy
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Accession number;04A0566241
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| Title;Anesthetic Management of a Patient with Osler-Rendu-Weber Disease During Laparoscopic Nephrectomy |
| Author;
KATO TAKAHIRO
(Hiroshima Univ., JPN)
KUSUNOKI SHINJI
(Hiroshima Univ., JPN)
KAWAMOTO MASASHI
(Hiroshima Univ., JPN)
YUGE TAKEFUMI
(Hiroshima Univ., JPN)
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Journal Title;Hiroshima Journal of Anesthesia
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Journal Code:S0305A
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ISSN:0385-1664
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VOL.39;NO.3/4;PAGE.77-79(2003)
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| Figure&Table&Reference;REF.16 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;Osler-Rendu-Weber disease (Osler disease) is an autosomal dominant disease characterized by telangiectatic mucosal lesions, visceral telangiectasis, and arteriovenous fistulae. We provided anesthetic management for a 45-year-old man with Osler disease, who was diagnosed with left renal cancer and scheduled for excision of the left kidney using a retroperitoneal laparoscopic procedure. The patient had experienced nasal bleeding once a week prior to the operation. The presence of hepatic arterio-portal fistulas was evaluated using CT, however, he showed no hepatic disfunction or high-output cardiac failure. General anesthesia was given without epidural catheterization. The trachea was carefully intubated using a fiberoptic bronchoscope and continuous cardiac output monitoring revealed a normal cardiopulmonary function during the procedure. We had no difficulties in management of bleeding, or with circulatory and respiratory controls during anesthesia, and the operation was completed uneventfully. Postoperative wound pain was controlled well using a continuous morphine infusion and patient-controlled analgesia. In general, it is important for anesthesiologists to give attention to arteriovenous malformation and bleeding tendency during anesthetic management of patients with Osler disease. We concluded that preoperative evaluation of the coexisting disorder and subsequent careful management through the perioperative period are vital for successful anesthetic management of hereditary hemorrhagic telangiectasia. (author abst.) |
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