Open AccessAnesthetic Management of Patients with Severe Peripheral Ischemia Due to Calciphylaxis
Author(s) -
Takafumi Horishita,
Kouichiro Minami,
Junichi Ogata,
Takeyoshi Sata
Publication year - 2004
Publication title -
anesthesia and analgesia/anesthesia and analgesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.404
H-Index - 201
eISSN - 1526-7598
pISSN - 0003-2999
DOI - 10.1213/01.ane.0000121960.22554.d7
Subject(s) - medicine , calciphylaxis , prostaglandin e1 , anesthesia , laser doppler velocimetry , blood flow , ischemia , fentanyl , surgery , peripheral , vascular disease , cardiology , disease
Calciphylaxis is a small-vessel disease associated with renal failure. Here, we report the management of a 43-yr-old man with calciphylaxis who received left lower leg amputation with prostaglandin E(1) (PGE(1)) under monitoring by laser Doppler blood flowmetry in the left second and third fingers. Anesthesia was induced with midazolam, fentanyl, and vecuronium and was maintained with oxygen, nitrous oxide, and sevoflurane. The peripheral blood flow varied and decreased gradually; therefore, we added PGE(1) 20 ng. kg(-1). min(-1), which increased blood flow of the tissues. Three weeks after the operation, we again anesthetized the patient. We maintained the blood flow with PGE(1) throughout anesthesia. Monitoring by laser Doppler blood flowmetry and PGE(1) 20 ng. kg(-1). min(-1) could be useful for patients with impaired peripheral circulation, as in calciphylaxis.