ジアゾキシド内服患者のインスリノーマ切除術における周術期管理の1症例

Perioperative Glycemic Control during Insulinoma Resection in Patients Controlled with Diazoxide：A Case Report

要旨

　インスリン分泌抑制薬ジアゾキシド内服患者のインスリノーマ切除術では，腫瘍摘出後ジアゾキシドの効果遷延による高血糖が問題となる。血糖を定期的に測定し，インスリンの投与，ブドウ糖投与の中止，また術中レミフェンタニル，術後持続硬膜外ブロックによる鎮痛で血糖値を200-250mg・dl⁻¹に管理できた。

　We experienced the perioperative management of insulinoma resection in a patient taking the insulin secretion inhibitor diazoxide. The preoperative blood glucose level was 110 mg・dl⁻¹, which was within the normal range. Perioperative blood glucose levels reached a peak of 232 mg・dl⁻¹ after resection and decreased slowly after surgery. No abnormal perioperative hyperglycemia was observed, and perioperative glycemic control was possible with insulin and sugar-free fluids, intraoperative remifentanil, and postoperative analgesia maintained with continuous epidural block.