Sevoflurane麻醉中發生痙攣

Seizure Attack during Partial Hepatectomy in a Living Donor for Liver Transplantation under Sevoflurane Anesthesia

一名23歲男性進行肝移植捐肝手術，全身麻醉以fentanyl, propofol作為引導藥物，sevoflurane做維持麻醉劑。氣管內管放置及手術中之肌肉鬆弛均以rocuronium達成。在手術進行十一小時後有輕度發熱並發生全身性痙攣。在積極處理後手術順利完成，病人於恢復室中清醒並順利拔除氣管內管，並無任何不適之主訴。其原因在此做一探討。

We report a case of generalized convulsion during partial hepatectomy for the purpose of organ donation for syngenesioplastic liver transplantation under sevoflurane anesthesia. This 23-year-old male Taiwanese living donor had no history of epilepsy. Anesthesia was inducted with fentanyl, propofol and rocuronium was used to facilitate endotracheal intubation. Sevoflurane in the mixture of oxygen and air and rocuronium were used for maintenance of anesthesia. Generalized convulsion with mild fever was observed 11 hours after the start of surgery when the surgeons happened to take a recess pending the removal of the recipient's liver. Convulsive episode subsided after aggressive management. Another 3 hours were required to complete the operation and the patient woke up in the postanesthesia room uneventfully.