caa a22 4500 445374527 CHVBK 20180317142958.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s00540-011-1102-y doi (NATIONALLICENCE)springer-10.1007/s00540-011-1102-y Anesthesia for a 228-kg patient (body mass index, 90.6) undergoing laparoscopic sleeve gastrectomy [Elektronische Daten] [Tomoki Nishiyama, Yumiko Kohno, Keiko Koishi] We undertook anesthesia of a 40-year-old woman with body weight of 228kg and body mass index (BMI) of 90.6kg/m2 who was undergoing laparoscopic sleeve gastrectomy. This case may be the largest known patient undergoing general anesthesia in our country. Anesthesia was induced in a 30° head-up position with midazolam, fentanyl, droperidol, and inhalation of sevoflurane and nitrous oxide without muscle relaxants, and maintained with propofol, remifentanil, and pancuronium under pressure-controlled ventilation. The Airway Scope could not be inserted into her mouth, but her trachea was successfully intubated with a Macintosh laryngoscope. Dosages of anesthetics and fluid infusion rate were calculated first per ideal body weight. Then, infusion of propofol and remifentanil and administration of muscle relaxant were controlled by bispectral index, hemodynamics, and train-of-four response, respectively. Postoperative 12-h pressure-controlled ventilation and pain management by subcutaneous infusion of fentanyl and droperidol were successful. Subcutaneous heparin 5,000 units twice per day postoperatively did not induce thromboembolism. Japanese Society of Anesthesiologists, 2011 Bariatric surgery nationallicence Super-obese nationallicence General anesthesia nationallicence Intravenous anesthetics nationallicence Nishiyama Tomoki Department of Anesthesiology and Critical Care, Higashi Omiya General Hospital, 5-18 Higashi Omiya Minuma-ku, Saitama, 337-0051, Saitama, Japan aut Kohno Yumiko Department of Anesthesiology and Critical Care, Higashi Omiya General Hospital, 5-18 Higashi Omiya Minuma-ku, Saitama, 337-0051, Saitama, Japan aut Koishi Keiko Department of Anesthesiology and Critical Care, Higashi Omiya General Hospital, 5-18 Higashi Omiya Minuma-ku, Saitama, 337-0051, Saitama, Japan aut Journal of Anesthesia Springer Japan 25/2(2011-04-01), 278-281 0913-8668 25:2<278 2011 25 540 https://doi.org/10.1007/s00540-011-1102-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-011-1102-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Nishiyama Tomoki Department of Anesthesiology and Critical Care, Higashi Omiya General Hospital, 5-18 Higashi Omiya Minuma-ku, Saitama, 337-0051, Saitama, Japan aut NATIONALLICENCE 700 1- Kohno Yumiko Department of Anesthesiology and Critical Care, Higashi Omiya General Hospital, 5-18 Higashi Omiya Minuma-ku, Saitama, 337-0051, Saitama, Japan aut NATIONALLICENCE 700 1- Koishi Keiko Department of Anesthesiology and Critical Care, Higashi Omiya General Hospital, 5-18 Higashi Omiya Minuma-ku, Saitama, 337-0051, Saitama, Japan aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/2(2011-04-01), 278-281 0913-8668 25:2<278 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer