7세 심실중격결손증 환아에서 다발성 뇌동맥류수술을 위한 마취

Abstract

Multiple cerebral aneurysms in children are rare lesions, occurring at a frequency of approximately 0.5% to 4.6%. In children, infective endocarditis from congenital or rheumatic heart disease are the important causes of cerebral mycotic aneurysms. Subarachnoid hemorrhage, most commonly caused by the rupture of an intracranial anurysm is associated with mortality and morbidity. We reported a case of multiple cerebral aneurysms in a 7 year old child with ventricular septal defect (VSD) in operation of the two times performed under general anesthesia. He was scheduled for elective surgery for clipping of cerebral aneurysm in ASA physical status II. For premedication, he was administered triflupromazine 10 mg (Veprin®) and glycopyrrolate 0.1 mg IM 1 hour prior to induction. Induction was established with thiopental, vecuronium after preoxygenation. N2O/O2 (2 L/min：2 L/min), isoflurane and vecuronium were administered for maintenance. For monitoring, ECG, direct arterial pressure, CVP, ETCO2 were performed. In second operation, we were performed the general anesthesia the same as the first operation. He had discharged in coma state on 4 day after the second operation hopelessly. (Korean J Anesthesiol 1999; 36: 916∼920)