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General Anesthesia for Patients With Cyclic Vomiting Syndrome and Obesity: A Case Report.
Kuroda, Hidetaka; Kaneko, Rumi; Katagiri, Norika; Kagawa, Keita; Saito, Natsuki; Sasaki, Yoko; Kuroda-Ohgi, Kazumi; Kuroda, Yukiko; Kuroda, Shinsuke; Tsukimoto, Shota; Ishikawa, Noboru; Abe, Takahiro; Sanuki, Takuro.
Afiliación
  • Kuroda H; Department of Dental Anesthesiology, Kanagawa Dental University, Kanagawa, JPN.
  • Kaneko R; Department of Anesthesiology, Dokkyo Medical University Saitama Medical Center, Saitama, JPN.
  • Katagiri N; Department of Dental Anesthesiology, Kanagawa Dental University, Kanagawa, JPN.
  • Kagawa K; Department of Dental Anesthesiology, Kanagawa Dental University, Kanagawa, JPN.
  • Saito N; Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, JPN.
  • Sasaki Y; Department of Anesthesiology, Saitama Medical University International Medical Center, Saitama, JPN.
  • Kuroda-Ohgi K; Prosthodontics, White Dental Clinic, Gunma, JPN.
  • Kuroda Y; Pediatric Dentistry, White Dental Clinic, Gunma, JPN.
  • Kuroda S; Endodontics, White Dental Clinic, Gunma, JPN.
  • Tsukimoto S; Department of Dental Anesthesiology, Kanagawa Dental University, Kanagawa, JPN.
  • Ishikawa N; Department of Forensic Odontology and Anthropology, Tokyo Dental College, Tokyo, JPN.
  • Abe T; Department of Oral and Maxillofacial Surgery, Kanagawa Dental University, Kanagawa, JPN.
  • Sanuki T; Department of Dental Anesthesiology, Kanagawa Dental University, Kanagawa, JPN.
Cureus ; 16(7): e65130, 2024 Jul.
Article en En | MEDLINE | ID: mdl-39171030
ABSTRACT
Cyclic vomiting syndrome (CVS) is a chronic digestive disorder characterized by recurrent episodes of severe nausea and vomiting. The perioperative management of patients with CVS undergoing general anesthesia is challenging, especially when combined with obesity. This case report describes the successful management of a patient with CVS and obesity who underwent dental surgery under general anesthesia. A 21-year-old woman with CVS, obesity (body mass index, 35), and intellectual disability was scheduled for tooth extraction and composite resin restoration under general anesthesia. The patient was diagnosed with CVS at the age of 20 years with frequent vomiting attacks requiring hospitalization. Surgery was scheduled during the CVS remission to reduce the risk of perioperative vomiting. Preoperative laboratory test results were normal, including serum adrenocorticotropic hormone (ACTH), anti-diuretic hormone (ADH), and cortisol levels. General anesthesia was induced using remifentanil and propofol. Nasal endotracheal intubation was performed after rocuronium administration. Local anesthesia (2% lidocaine with 180,000 epinephrine) was used for all dental procedures. Postoperatively, midazolam was administered to control agitation. No postoperative vomiting occurred. Serum ACTH, ADH, and cortisol levels showed no significant changes before and after anesthesia, suggesting that hypothalamic-pituitary-adrenal (HPA) axis activation due to surgical stress did not occur. This case highlights the importance of careful perioperative planning and monitoring stress-related hormone levels in patients with CVS or obesity. An anesthetic approach using midazolam may effectively suppress HPA axis activation and prevent postoperative vomiting.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Cureus Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Cureus Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos