メチルフェニデート徐放錠を内服しているADHD患児の麻酔経験

Anesthetic Management of a Pediatric ADHD Patient Taking Methylphenidate Sustained Release Tablets（Concerta®）

要旨

　メチルフェニデート徐放錠を内服する注意欠如・多動症（attention deficit hyperactivity disorder：ADHD）の12歳男児に対し，骨接合術の全身麻酔を行った。ADHDの病態，メチルフェニデート徐放錠の薬物動態を元に，当日休薬の判断をした。術中覚醒を生じさせることなく，無事に麻酔を行うことができた。

　A 12-year-old boy was scheduled for osteosynthesis with an intramedullary nail to a left femoral diaphysis fracture. He was under treatment with methylphenidate（MPH）sustained release tablets（Concerta^® 18 mg）for attention deficit hyperactivity disorder（ADHD）, but on the day of this surgery he was off this medication. Anesthesia was administered with a femoral nerve block and general anesthesia. The patient was successfully managed with anesthesia at the usual anesthetic dosage.

　There is currently no uniform consensus or definite guideline regarding the necessity and duration of withdrawal from extended-release MPH tablets during the perioperative period. Analyses of more cases and further research are necessary.