全身麻酔後の認知機能障害から大脳基底核症候群が疑われた1症例

Cognitive Dysfunction after General Anesthesia in a Patient with Suspected Corticobasal Syndrome

要旨

　全身麻酔からの覚醒時に，常時開眼したままで無反応であった症例を経験した。術後集中治療室へ収容し，パーキンソン病を疑いレボドパを投与した。30分後に全覚醒したが，筋固縮などを認めた。精査で大脳基底核症候群であることが判明した。術後意識回復困難の原因の一つに本疾患があることも念頭に置き，他科と協議する必要があった。

　We describe our observation of cognitive dysfunction in a female patient with suspected corticobasal syndrome who had received general anesthesia when she underwent a laparoscopic ovariectomy. The anesthesia regimen was remifentanyl, propofol, rocuronium, and fentanyl（total 150 μg）. Sugammadex was administered after the ovariectomy, and the patient’s spontaneous respiratory rate and tidal volume were stable. She was then extubated, but she did not respond although her eyes opened. An arterial blood gas test and brain MRI scan showed no organic abnormalities. She woke up completely -30 min after her admission to the intensive care unit. Rigidity of upper-arm muscles in both arms was observed. Based on the clinical neurological findings and radioisotope inspection, we diagnosed corticobasal syndrome.