妊婦の褐色細胞腫に対して，腹腔鏡下摘出術を硬膜外併用全身麻酔で施行した1症例

A Laparoscopic Excision of Pheochromocytoma in a Pregnant Woman Under General Anesthesia with Epidural Anesthesia

要旨

　45歳，女性，妊娠15週の腹腔鏡下副腎腫瘍摘出術を硬膜外併用全身麻酔で管理した。術前にα遮断薬で血圧を正常化し，術中の母体の血圧の上下限値を胎児循環に留意して設定した。全静脈麻酔で導入・維持を行い，心拍出量や体血管抵抗を測定することで安全に管理しえた。

　A 45-year-old 15 weeks’ pregnant woman underwent a laparoscopic adrenal tumor removal under general anesthesia with epidural anesthesia. Her preoperative blood pressure was normalized with alpha-blockers, and the safety margin of the maternal blood pressure concerning the fetal circulation was determined. Total intravenous anesthesia was administered, and the intraoperative monitoring of the patient’s cardiac output and systemic vascular resistance contributed to safe procedures.