Journal of clinical anesthesia
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Case Reports
Propofol anesthesia for cesarean section successfully managed in a patient with moyamoya disease.
We report a case of general anesthesia in a 25 year-old female patient with moyamoya disease who presented for cesarean section. General anesthesia was induced with propofol 100 mg, succinylcholine 50 mg, and nicardipine 1 mg intravenously (i.v.), and maintained with 60% nitrous oxide in oxygen. Just after the clamp of the umbilical cord, propofol 10 mg/kg/hr following propofol 50 mg pentazocine 15 mg vecuronium 8 mg, and methylergometrine maleate 0.2 mg were given i.v. ⋯ For the anesthetic management of moyamoya disease patients, especially in delivery, it is important to avoid hemodynamic changes and to maintain cerebral blood flow (CBF). We used propofol for hemodynamic stability and avoided hyperventilation so as to maintain CBF. We successfully managed the patient perioperatively.
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To determine the neuromuscular blocking effect and recovery profile of cisatracurium besylate in children after administration of a bolus dose that was twice the estimated dose required to produce 95% of the maximum effect (2 x ED95; 0.08 mg/kg) followed by an infusion during halothane-nitrous oxide anesthesia. ⋯ Cisatracurium provided maximal neuromuscular block, cardiovascular stability, and predictable recovery at the doses tested. In view of this finding, cisatracurium should be a useful intermediate-duration neuromuscular blocking drug for children during general anesthesia.