A case of delayed emergence from anesthesia after scoliosis surgery in a patient with Fontan circulation
2021 Volume 25 Issue 1 Pages 67-70
Details
2021 Volume 25 Issue 1 Pages 67-70
We report a patient with Fontan circulation who experienced delayed emergence from anesthesia after scoliosis surgery.
Before the surgery, serum makers for developing liver fibrosis were slightly elevated, but transaminase levels were within normal range.
She underwent surgery in the prone position. Despite stable hemodynamics with 10-13 mmHg of central venous pressure and adequate urine output, delayed emergence from anesthesia was observed. We thought that the cause was delayed drug metabolism because of postoperative liver damage.
This patient likely suffered from a Fontan associated liver disease as she was a long-term Fontan patient. Therefore, it was considered that latent hepatic dysfunction and hepatic artery dominance on her hepatic circulation were the factors that contributed to the postoperative liver damage.
We need to evaluate liver function carefully, and give an anesthetic management and circulation management based on the characteristic hepatic circulation of FALD in noncardiac surgery for patients with long-term Fontan circulation.
